Policy Leadership

With a vital interest and recognized expertise, Amerigroup remains at the forefront in the national discussion on health care policy. 

To improve access to quality care for all Americans, we believe strongly in the following three concepts and initiatives: pursuing privatization, placing an emphasis on independence, and covering the continuum of caring for all individuals in need. 

Pursue Privatization

The push to privatize public programs continues, whether in new populations, regions or programs.

Emphasize Independence

Secondly, publicly sponsored programs are increasingly about ensuring independence, whether it's for the young mom who needs assistance with health care to be self-sufficient, the elderly person wishing to age in place or the person with disabilities who wants to live in the community.

Cover the Continuum

Third, more and more states are focused on what we'll call continuum planning. What we're learning is that there is much more movement into and out of government programs than previously imagined. There are many more middle-income families utilizing CHIP and Medicaid, particularly now among seniors. The old silos are gone as we consider a continuum of coverage that not only tracks birth to death, but also safety nets through private coverage. By focusing on that critical mass around the edges of these programs, we can see significant opportunities that are consistent with our core mission.

Vision for Success

To be successful in this new environment, private sector companies will need specific experience, targeted focus and several core competencies including first, an ability to deliver and report quality. Amerigroup has talked in the past about states becoming prudent purchasers. Now, with all of the data available, they really can reward and choose plans based on performance.

Second: an organizational commitment to compliance. With the blurring of lines among public programs, there is an even greater need for health plans to implement comprehensive compliance programs. Amerigroup has worked with former HHS Inspector General Dick Kusserow for more than a year to develop and implement what we believe is a state-of-the-art compliance program.

Next, community involvement beyond traditional outreach. This means more personal, direct interaction, whether in a planned neighborhood, through the call center or in a member's home with intensive case managers. The companies that will succeed are the ones who know the needs and challenges of their members first-hand.

Next, an ability to incorporate long-term costs containment features. We've moved beyond basic trend control with the states. While we're working with states today to implement managed care models for the Aged, Blind and Disabled populations, we're already focused on developing the tools and outcome metrics for the next generation of long-term care services.

And finally, to succeed in this environment, companies will need a deeper and broader involvement with government at both elected and regulatory levels as we truly partner with them to innovate and develop programs that meet their needs and their needs of their citizens. This is not for feeble companies or inexperienced ones or those without a sizable commitment of resources, talent and focus.

Managed care has proven to be successful as it relates to the traditional Medicaid population of moms and kids. But, the challenges beyond this are great. A few companies including Amerigroup have also proven a capacity to contain costs and improve the outcomes within the Aged Blind and Disabled population. The bottom line is the states have an unavoidable crisis coming. But, companies like Amerigroup are poised to help solve it.