Friday, April 29, 2016

Medicaid Managed Care Final Rule; Implications as we see "Medicaidization" of Health Care

On April 25, 2016, CMS released the massive (1425 page) Medicaid Managed Care final rule.  This is the first update in many years and reflects CMS's acknowledgement that Medicaid is transforming from a classical state-managed system to an outsourced, commercially managed, managed care system with exceptional budget constraints.

The rule is here.  An insightful summary by health policy guru Timothy Jost, online at Health Affairs, here.  More after the break.

CMS press release here.  More CMS links and fact sheets, here.

For Kaiser Foundation's website on Medicaid managed care, here.  

Leading Medicaid managed care providers, like Centene and Molina, will likely play important growing roles as other insurance products evacuate the Exchange space created by the Affordable Care Act.   For the latter in current national press, see here and here.  

Some refer to this as the Medicaidization of American health care.   Although this term has only 1000 Google hits today, that number will likely skyrocket in the next year or two.  (For the agenda of the May 2016 Medicaid managed care congress in Baltimore, see here.)  But I would start filing events like the purchase of HealthNet by Centene (here) or the growth of Centene in Exchanges as the "Medicaidization" trend.


Medicaid Word Cloud....