Those who participated in the interviews conducted for this report provided a wealth of information on how their Medicaid PCCM programs have evolved and the actions they have taken to get their programs to their present incarnations. These state officials had a myriad of advice to share with states looking to replicate the innovations they have implemented.
The most frequent advice given by case-study states is to use the principles and tools of MCOs, such as prior authorization, performance standards, benchmarks, and quality strategies. This was asserted by the majority of case-study states. Other advice includes
- Know what the desired accomplishments are, from day one; have specific goals and steps for reaching them; and communicate these goals and steps to key players (including providers).
- To work well, the program must be both provider- and beneficiary-focused.
- Evolve slowly: start small and learn from pilot sites before expanding.
- Keep building a base of political support for the program.