Medicaid Managed Care Needs Better Oversight, Networks, Care Coordination, and Physician Payment - 06/28/2018
Texas’ Medicaid managed care system faces grave but surmountable challenges that must be addressed with all due haste, beginning with enhanced scrutiny not only of the health plans but also of how the state’s own actions, including deep funding cuts and insufficient agency staff, jeopardize Medicaid’s ability to care for the neediest among us. At the same time, we must recognize not all Medicaid MCOs are created equal. Some are quite clearly poor performers while others go above and beyond what the state asks of them to ensure their enrollees receive the care they need, including expanding availability of specialty services and improving maternal health outcomes. Texas must learn from and replicate the best practices of the highest- performing plans rather than just punishing the bad apples.