Freedom of choice: Medicaid, managed care, and California family planning clinics.
Access to out-of-plan family planning services for Medicaid beneficiaries enrolled in managed care plans in California has been limited by poor relationships between family planning clinics and contracting managed care plans. Plans either delay or fail to reimburse claims from non-network family planning agencies; family planning staff are unmotivated to identify managed care members through financial screening, to cover costs with other funds, or to refer members back to plan. In addition, plans and clinics fail to coordinate the care of managed care clients by sharing medical records. Based on findings from a pilot project, California will try to facilitate relationships between plans and family planning agencies rather than directly pay out-of-plan claims.
Aved
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Barbara Aved Associates, Sacramento, USA.
Michaels
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D002140:California; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007373:Interinstitutional Relations; D015141:Los Angeles; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D020403:Patient Freedom of Choice Laws; D010865:Pilot Projects; D014481:United States