States are increasingly relying on Medicaid managed care programs to contain rising costs and to improve quality of care. If cost savings are to be realized and enrollees are to benefit from the promises of managed care, Medicaid beneficiaries must understand: 1)how to choose a plan; 2)how to navigate a plan; 3)how to engage in healthy behaviors. The complexity of managed care programs adds to the challenge of educating beneficiaries. Keeping information current and pressures to enroll large numbers of people into mandatory programs in short time frames creates barriers to effective consumer education. Beneficiaries themselves face obstacles to understanding managed care such as language, low literacy levels and an historic lack of access to services. How cities have responded to these challenges is varied. The Center for Health and Public Service Research of New University and The Community Service Society of New York with funds from the Commonwealth Fund conducted a study of managed care efforts in 13 cities across the country. The study documented the current state of the art and will assist policy makers in developing and sustaining programs to help beneficiaries understand, use, and benefit from Medicaid managed care. Data was collected by reviewing state agency contracts with MCOs and enrollment brokers, interviews with state Medicaid and enrollment broker representatives, review of enrollment packets, and some site visits. Findings include strengths and weaknesses of educational programs and highlight areas for improvement.
Learning Objectives: At the conclusion of this session, the participant will be able to: 1. Identify 13 cities programs for educating Medicaid recipients about managed care; 2. Recognize challenges and the state of the art of educational programs geared toward Medicaid recipients; 3. Articulate program areas for states/cities to improve their educational programs on Medicaid managed care
Keywords: Medicaid Managed Care, Education
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.