The Medicaid Institute™ at United Hospital Fund

An initiative of United Hospital Fund

Better Managing Patient Care

The majority of New York's beneficiaries are now enrolled in Medicaid managed care (MMC), and policymakers are extending MMC's reach to include more disabled and elderly enrollees; the state implemented a policy in 2006, for example, requiring certain disabled beneficiaries in New York City to join a managed care plan. While MMC holds promise for improving services, New York's experience to date indicates that meeting that promise will require changes in the ways providers and patients, respectively, deliver and access health care services.

Rethinking service delivery for "high-cost" Medicaid beneficiaries who typically remain in fee-for-service (as opposed to MMC) is also a priority because this small share of enrollees represents some of the program's most complex patients and accounts for a large share of Medicaid spending. Through the establishment of the Medicaid High-Cost Care Initiative, the Fund, collaborating with researchers and clinicians, explored opportunities to improve Medicaid service delivery for these patients.

Related Publications

Providing Behavioral Health Services to Medicaid Managed Care Enrollees      

Published: 2009

A report from the United Hospital Fund's Medicaid Institute™ concludes that, for Medicaid beneficiaries with chronic physical health conditions and serious and persistent mental illness, the more integration of physical and behavioral health care services the better.

Rethinking Service Delivery for High-Cost Medicaid Patients      

Published: 2009

This report lays out the formidable challenges to improving care for certain high-cost Medicaid beneficiaries, focusing on those with multiple and substantial needs who rely disproportionately on costly hospital inpatient services.

Presentation of "Medicaid Managed Care for Persons with Severe Mental Illness in New York : Challenges and Implications"      

Published: 2008

Delivered at the Third National Medicaid Congress in Washington, DC, this presentation reviews the findings and policy implications from the Medicaid Institute™ report Medicaid Managed Care for Persons with Severe Mental Illness: Challenges and Implications.

Medicaid Managed Care Reexamined      

Published: 2008

This publication is the most comprehensive independent report produced in recent years examining the status of managed care for Medicaid beneficiaries in New York.

Medicaid Managed Care for Persons with Severe Mental Illness: Challenges and Implications      

Published: 2007

Focusing on the latest group of disabled Medicaid beneficiaries required to join a managed care plan, this issue brief from the Fund's Medicaid Institute™ illustrates the demands of care management for Medicaid's most complex and costly cases.

New York's SSI Medicaid Beneficiaries      

Published: 2006

This new issue brief reviews the characteristics and experiences of Supplemental Security Income (SSI) Medicaid enrollees—who are poor and elderly or disabled—under the fee-for-service Medicaid program and explores the implications of a new policy mandating that some of these beneficiaries must now enroll in a Medicaid managed care plan.

 

Medicaid Institute™ at United Hospital Fund
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