Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

Methods of Documentation VI: Case Management Model

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...

Methods Of Healthcare Delivery System

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...

Introduction To Health Care Delivery System

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...

Standards of Care I

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:

Planning Nursing Care I

Planning Nursing Care I

The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...

Documentation in Long-Term and Home Healthcare Setting

Documentation in Long-Term and Home Healthcare Setting

Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same journal

Highlights from the HFM blog.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

Same journal

Hospitals face challenges from Medicare cost and payment trends.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

Same journal

The fate of value-based care with an ACA repeal.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

Same journal

Beyond the Medicare annual well visit: maximizing revenue for hospital-owned practices.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

Same journal

Incorporating social determinants into population health management.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

Same journal

Health Care 2020 Part 3: Consolidation.

Healthcare financial management : journal of the Healthcare Financial Management Association·2018

See all related articles

Search research articles

Related Experiment Video

Updated: May 23, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

Preparing for Medicaid managed care.

¹Adreima, Phoenix, USA. cperez@adreima.com

Healthcare Financial Management : Journal of the Healthcare Financial Management Association

|April 25, 2012

Summary

This summary is machine-generated.

As Medicaid enrollment grows, healthcare providers should contract with Medicaid managed care plans. Developing a clear strategy and optimizing front-end revenue cycle processes are crucial for successful engagement with these plans.

More Related Videos

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Related Experiment Videos

Last Updated: May 23, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Area of Science:

Healthcare Administration
Health Insurance Policy

Background:

Medicaid enrollment is increasing, presenting both challenges and opportunities for healthcare providers.
Managed care models are becoming more prevalent within Medicaid programs.

Purpose of the Study:

To highlight the benefits for hospitals and health systems in contracting with Medicaid managed care plans.
To outline essential strategic considerations for providers engaging with Medicaid managed care.

Main Methods:

Analysis of current trends in Medicaid enrollment and managed care.
Review of essential components for provider contracting strategies.

Main Results:

Contracting with Medicaid managed care plans can yield significant benefits for healthcare providers.
A proactive strategy is necessary before initiating the contracting process.

Conclusions:

Healthcare providers must develop a comprehensive Medicaid managed care strategy.
Optimizing front-end revenue cycle processes, including patient access, billing, and denials management, is critical for successful collaboration with Medicaid managed care plans.