May 29, 2013 -- In a new report from the Urban Institute, researchers examine the ability of eight states’ Medicaid managed care programs to seamlessly handle the influx of new enrollees in 2014. The authors say the readiness of managed care programs is key, as they already serve a significant portion of Medicaid enrollees and the numbers will increase after expansion.
Researchers conducted interviews in Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia, and learned that health care stakeholders believe managed care programs are ready to absorb more Medicaid beneficiaries in their plans. In each of the states, experts cited a history of strong managed care programs operating in their state, with solid organizational and operational infrastructures to build upon. Most stakeholders said that managed care programs would easily take on the increased number of Medicaid enrollees.
“Millions of uninsured people will gain coverage when the Medicaid expansion kicks in early next year,” said Andy Hyman, who leads health coverage programs at the Robert Wood Johnson Foundation. “States’ Medicaid managed care programs will serve the majority of these new enrollees, so they need to be prepared to help care for more people. The good news is that the programs are ready for all comers.”
Stakeholders discussed whether the publicly offered plans will also be available in the private health insurance exchanges. The researchers found that some, but not all, of the plans will be offered in both, which they said should simplify the enrollment process for those individuals who frequently move between public and private coverage as their income fluctuates.
Stakeholders expressed some concerns about the ability of states’ information technology (IT) systems to seamlessly handle an increased volume of eligibility and enrollment processes. Most of those interviewed said steps need to be taken immediately to put adequate IT systems in place before 2014.
The report was made possible by a grant from the Robert Wood Johnson Foundation.
