This report responds to a request from the Committees on Appropriations of the U.S. House of Representatives and the U.S. Senate. It examines the rapid proliferation of telehealth modalities when providing medical care and highlights HHS’s efforts to identify and address obstacles to e-health and telemedicine. The report explains ways that advan
1. In general, "TANF" refers to other poverty-related populations in addition to TANF beneficiaries. However, Alabama makes a distinction between SOBRA women and SOBRA children; SOBRA children are mandatorily enrolled, while SOBRA adults are not eligible.
Case Study States' Enrollment Policies Alabama Florida Iowa Maine North Carolina Oklahoma Texas Virginia Patient 1 st
Emerging Practices in Medicaid Primary Care Case Management Programs. Appendix B: North Carolina Access II & III Core Elements of the Asthma Disease Management Program
Build Capacity for Routine Assessment of Asthma
Emerging Practices in Medicaid Primary Care Case Management Programs. Appendix A: Case Study States' Contacts
Charlene J. Benson Director, Medicaid Care Management Oklahoma Health Care Authority 4545 North Lincoln Suite 124 Oklahoma City, OK 73105 405-522-7366 email@example.com Scott F. Cannady Managed Care Unit Supervisor Department of Medical Assistance Services P.O. Box 537 Richmond, VA 23204 804-786-5445 SCannady@dmas.
As Medicaid managed care has evolved during the past decade, states have balanced the development of their PCCM programs with the growth and/or decline of risk-based managed care. Each state has taken a slightly different approach, depending in part on the state's particular managed care environment. Some states developed PCCM as a stepping stone
State advice on enrollment focused mostly on additional roles a contracted enrollment broker can play. Use the enrollment broker to recruit providers, in order to learn the area before starting member enrollment. Use the enrollment broker for member education. Do not try to enroll a great number of people into a mandatory program all at onc
States with active care coordination components to their PCCM programs reported that providers and beneficiaries found them very helpful. Other recommendations included Recognize that the referral process is key to managing services Make prior authorization and other state-required procedures as hassle-free as possible for providers. Employ
States with incentive payment systems noted that these systems can be very effective in reinforcing the state's key program goals.
Case-study states have implemented a broad range of mechanisms to ensure high quality care for members. Therefore, their advice covers a wide range of issues.
Case study state officials agreed that provider commitment is the key to their success. Their advice stressed identifying and implementing ways to obtain the buy-in of a wide variety of providers.
Advice on organizational structure emphasized the need for sufficient state investment of personnel and resources:
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