Quality & Pay For Performance

Issue Defined

Medicaid managed care organizations are stereotyped as providing the least amount of care possible to make a larger profit, while Medicaid is seen as a poor-quality program that has little impact on access to care or health.

Recommendations

The use of a medical home through a managed care model improves the quality and access of care for the Medicaid population with guidelines placed on the managed care organizations through their contractual obligations.

Savings Outlook

Managed care delivery has been able to reduce the rate of Medicaid's cost growth in comparison to fee-for-service models. From 2000 to 2002 in New York, the fee-for-service model's costs grew at 4.9% while the managed care programs cost grew at 2.3%.