Date: 03/05/2009

Medicaid Managed Care


Votes: View--> Action Taken:

03:02 PM -- Medicaid Managed Care

Donna Checkett, Schaller Anderson, began the presentation on Medicaid managed care and distributed a handout to the committee (Attachment B). She gave an overview of Schaller Anderson. She described data related to the Medicaid program nationally, noting that 41 percent of all births are paid for by Medicaid and there are 8.8 million individuals who are dually eligible for both Medicaid and Medicare. She described the goals of Medicaid managed care, including slowing the rate of growth of cost trends, improving access to care, improving and assuring quality of care, and establishing and promoting the use of medical homes. She stated that by the end of 2006, 48 states and the District of Columbia had some form of Medicaid managed care.


03:09 PM

Ms. Checkett described models of Medicaid managed care, including risk-based, administrative services organization, and care management models. She described Schaller Anderson's care delivery system, which includes the use of medical homes for all enrollees and modeling systems. She described observations that the company has made regarding its managed care programs. She cautioned that the model makes it difficult to immediately quantify cost savings. Ms. Checkett described the essentials she believes must be part of a Medicaid delivery service system, including medical homes, 24-hour access to services, integration of claims and authorizations, and provider engagement. She responded to questions from Representative Gagliardi regarding whether, if the state contracts with Schaller Anderson, all Medicaid beneficiaries would be enrolled in Aetna. She further responded to questions from Representative Acree regarding improvement in client health outcomes.

03:25 PM

Craig Bass, Schaller Anderson, responded to questions from Representative Swalm regarding electronic medical records. He noted that the economic stimulus package includes funding to promote electronic medical records. Mr. Bass further responded to questions from Senator Carroll regarding the cost of Schaller Anderson's services. He stated that there will be an up-front expense, but over time, medical costs will be reduced.