Medicaid must ensure that it is meeting the needs of patients with multiple chronic conditions who receive care through the program’s managed care plans. This was the view expressed by Philips Healthcare in response to a recent Centers for Medicare & Medicaid Services proposed rule on Medicaid managed care.
Medicaid is a joint federal-state program providing health care for low-income people. Some 75% of Medicaid patients are enrolled in managed care plans through the program.
Specifically, Philips urged CMS to:
- Require states to describe the requirements they impose on managed care plans regarding care for Medicaid patients with multiple chronic conditions.
- Ensure that state Medicaid payments to managed care plans take into account the true costs of caring for such patients.
- Ensure that accessibility standards applied to Medicaid managed care programs address the care coordination and health coach needs of those with multiple chronic conditions.
- Encourage states to adopt incentives that reward managed care plans for providing team-based, high-touch/high-tech programs to improve quality for such patients.