Financial, operational issues entangle Medicaid managed care.
Federal and state governments may soon require provision of managed care to the Medicaid eligible segment of the community. HMO financial managers must develop financial and operational plans prior to entering into negotiations for the development of a contract with a state. Key financial and operational issues related to Medicaid aid categories, contracting with providers, general administration, and product design must be addressed to minimize financial risk.
Kalkhof
C J
CJ
Group Health Inc., Buffalo, NY.
D003284:Contract Services / Q000191:economics; D003365:Costs and Cost Analysis; D003659:Decision Making, Organizational; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005376:Financial Management / Q000379:methods*; D006279:Health Maintenance Organizations / Q000191:economics* / Q000458:organization & administration; D015273:Insurance Selection Bias; D008484:Medicaid / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D011357:Product Line Management; D013219:State Government; D014481:United States