Week#6-To Do List-SMHS 1. Week 6: Readings Please use the assigned course book to read the following sections: Part V: Special Markets Chapter 25: Medicaid Managed Health Care Chapter 26: The Military Managed Care Health System Chapter 27: Managed Care in a Global Content Click on the links below to access additional recommended readings: https://www.youtube.com/watch?v=wtB9VQ3eRRk&list=PL5AJoKAXemI5ufCHHM8ga3YcU18zBWyAa https://www.youtube.com/watch?v=OCgwxXV049s https://www.youtube.com/watch?v=LD3L5CSaYLY 2. Week 6: Assignment The use of Medicaid use services among consumers varies state by state. This assignment calls for you to report on the Medicaid profiles of 3 states, which can be found at the following website: http://medicaid.gov/Medicaid-CHIP-Program-Information/By-State/By-State.html Include within your report, all statistical data and charts that identify: Eligibility levels Enrollment data Targeted enrollment strategies used Participation rates 3. Week 6: Discussion What are some of the reasons Medicaid managed care is more complex than developing private sector managed care programs and has led to more specialized firms dominating this market? Medicaid Managed Health Care, The Military Managed Care Health System and Managed Care in a Global Context WEEK 6 LECTURE History of Medicaid Health coverage for the uninsured for over 45 years. Entitlement program established in 1965 as part of President Johnson’s “Great Society” Initially intended as a health coverage supplement for those receiving cash assistance (predominantly women of child bearing age and children). Overtime, Congress has expanded eligibility substantially to fill coverage gaps left by private insurance. Therefore, States have expanded their programs by (1) raising the income eligibility levels for aid categories; and (2) adding and/or expanding new populations. Medicaid pays for nearly 40% of all newborn deliveries and covers 1 in 4 children. Medicaid now provides benefits to more people than any other public or private insurance program, including Medicare. History of Medicaid When the Balanced Budget Act (BBA) was passed in 1997, it created Title XXI or the State’s Children Health Insurance Program (SCHIP)—a grant in aid statute, expanding eligibility for States to cover uninsured children who did not qualify for Medicaid Incentives (FFP) given to States increased the opportunity for more children to receive “medical assistance” From Dec 1999-Dec 2010, the SCHIP enrollment has grown from 2.7M to approximately 8M consumers Medicaid enrollment increased from 31.7M consumers in June 2000 to 58M in 2010 Access to Care Barriers In 2009, consumers covered by Medicaid and private insurance appear to have an equally low percentage of no usual source of care when compared to the uninsured. The evaluation of benefits reveals that only 60% of the covered services are federally mandated Managed Medicaid .