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mco
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in Out of Sight, Out of Mind? Measuring the Relationship between Privatization and Medicaid Self-Reporting
> Journal of Health Politics, Policy and Law
Published: 01 April 2018
Figure A1 Medicaid Commercial MCO Penetration and Medicaid Reporting Rates
More
Image
in Out of Sight, Out of Mind? Measuring the Relationship between Privatization and Medicaid Self-Reporting
> Journal of Health Politics, Policy and Law
Published: 01 April 2018
Figure A2 Privately Named Medicaid MCO Penetration and Medicaid Reporting Rates
More
Journal Article
J Health Polit Policy Law (2001) 26 (2): 291–326.
Published: 01 April 2001
...Peter D. Jacobson; Matthew L. Kanna This article provides an initial look at how managed care organizations(MCOs) might incorporate cost-effectiveness analysis (CEA) into their decision-making process and how the courts might respond. Because so few medical liability cases directly involve CEA, we...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1051–1060.
Published: 01 October 1999
... of managed care. Yet, real suf-
fering has occurred, and some of it is attributable to bad decisions made
by officials of managed care organizations (MCOs). But errors and
insensitivity to patients were part of the indemnity landscape as well, and
in spite of the publicity, there is no evidence...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1061–1070.
Published: 01 October 1999
... (e.g., mandatory external appeals, liability rights, and making
managed care organization [MCO] medical directors subject to the dis-
Journal of Health Politics, Policy and Law, Vol. 24, No. 5, October 1999. Copyright © 1999 by
Duke University Press.
1062 Journal of Health Politics, Policy...
Journal Article
J Health Polit Policy Law (2018) 43 (2): 137–183.
Published: 01 April 2018
...Figure A1 Medicaid Commercial MCO Penetration and Medicaid Reporting Rates ...
FIGURES
Journal Article
J Health Polit Policy Law (2019) 44 (6): 919–935.
Published: 01 December 2019
..., vulnerable population where SDOH are likely to be substantial factors in overall health. Second, state contracts with Medicaid managed care organizations (MCOs), which managed benefits for over two-thirds of Medicaid members as of 2016 (CMS 2018a ), create an opportunity for states to embed incentives...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1115–1126.
Published: 01 October 1999
... organizations (MCOs) and the private sector, so the
story goes, are not perfect, but the alternative—having legislatures man-
age health resources and bureaucracies make health care decisions—is
Funding provided by a Robert Wood Johnson Investigator award. Helpful comments were pro-
vided by Diane...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 933–936.
Published: 01 August 2015
... from these multiple perspectives, limiting the narrative to public officials, managed care organizations (MCOs), selected providers, and enrollee advocates. It is an innovative approach that yields a rich amount of information concerning the various groups. Bennett argues that these players, all...
Journal Article
J Health Polit Policy Law (2015) 40 (1): 245–255.
Published: 01 February 2015
... capitated managed care organizations (MCOs) and outlines several implementation challenges the CCO model faces. In 2009 House Bill 2009 established the Oregon Health Authority (OHA) as an independent agency. It also established the Patient-Centered Primary Care Home (PCPCH) program, to promote...
FIGURES
Journal Article
J Health Polit Policy Law (2008) 33 (6): 1107–1131.
Published: 01 December 2008
... (MCOs) were developed in the United States
several decades ago largely as a response to escalating health care costs.
Like “traditional” private health insurers of the 1960s and 1970s, most
Weiner et al. ■ Global Context of Managed Care, Private Insurance 1109
MCOs — such as health...
Journal Article
J Health Polit Policy Law (1997) 22 (3): 815–838.
Published: 01 June 1997
...; Congressional Research Ser-
vice 1993; Lewin–VHI 1995; Rowland et al. 1995). Under risk-based
capitation programs, states contract with managed care organizations
(MCOs)—which can include private health maintenance organizations
(HMOs) or prepaid health plans (PHPs) such as federally qualified health...
Journal Article
J Health Polit Policy Law (2015) 40 (1): 227–232.
Published: 01 February 2015
... care organization (MCO) that participates in Medicaid. ▪ Change in provider . This would occur when a person must change provider because his or her former provider is not in-network in the new program or carrier. This form of disruption, we should note, could occur even if the QHP and MCO are part...
Journal Article
J Health Polit Policy Law (2009) 34 (1): 5–35.
Published: 01 February 2009
... to contracting
with managed care organizations (MCOs). In Connecticut’s case, the
state actively recruited commercial MCOs to contract with the state to
provide services to Medicaid recipients. This changed the constellation
of actors in the policy network and traditional Medicaid safety-net pro-
viders...
Journal Article
J Health Polit Policy Law (2020) 45 (1): 153–164.
Published: 01 February 2020
.... States will have to balance the competitiveness of Buy-In plans to not drive out private plans while still working to keep costs low for beneficiaries. Making insurance plans available on the marketplace through MCOs might improve options for people currently eligible for insurance and may reduce...
Journal Article
J Health Polit Policy Law (2004) 29 (6): 1045–1072.
Published: 01 December 2004
... organizations [HMOs] or managed care
organizations [MCOs These entities take responsibility for both financ-
ing and delivery of care; to do so at competitive prices, they must bring
Journal of Health Politics, Policy and Law, Vol. 29, No. 6, December 2004. Copyright © 2004 by
Duke University Press.
1046...
Journal Article
J Health Polit Policy Law (1997) 22 (5): 1133–1189.
Published: 01 October 1997
... reduce patient access to providers, along with provider access to paying patients, so many providers have lobbied for AWP-FOC laws. In opposition are managed care organizations (MCOs), which want full freedom to contract selectively to control prices and utilization. This article comprehensively...
Journal Article
J Health Polit Policy Law (2016) 41 (2): 287–300.
Published: 01 April 2016
... and Reynolds 2014 ; Iowa Department of Human Services 2015d ). While the comprehensive nature of Iowa's Medicaid Modernization is unique among states, the program is generally consistent with national trends: as of 2014, thirty-nine states contracted with managed care organizations (MCOs) to provide...
Journal Article
J Health Polit Policy Law (2016) 41 (3): 315–354.
Published: 01 June 2016
... annual growth rates, Democrats controlled the White House and both houses of Congress. When the Balanced Budget Act of 1997 (BBA) was enacted, legislation that was expected to significantly increase managed care organization (MCO) participation and beneficiary enrollment, it was passed on a remarkably...
FIGURES
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Journal Article
J Health Polit Policy Law (2001) 26 (2): 439–446.
Published: 01 April 2001
...-
ically appropriate with little need to explain or justify their decisions.
Over the past quarter century, managed care organizations (MCOs)
have shifted power away from physicians to payers. MCOs required, in
one way or another, that doctors and medical...
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