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Promoting choice: lessons from managed Medicaid

I Fraser¹, E Chait, C Brach

¹Center for Organization and Delivery Studies, Agency for Health Care Policy and Research (AHCPR), Rockville, MD, USA.

Health Affairs (Project Hope)

|October 14, 1998

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Most Medicaid managed care enrollees choose their own health plan when systems prioritize choice. Lessons learned from seven states offer strategies for aligning programs, enhancing enrollment, and improving care continuity.

Area of Science:

Health Services Research
Public Health Policy
Healthcare Management

Background:

Medicaid managed care programs are increasingly common.
Understanding enrollee choice is crucial for program success.
State-specific design impacts program outcomes.

Purpose of the Study:

To analyze factors influencing health plan selection in Medicaid managed care.
To identify best practices for designing state programs that facilitate enrollee choice.
To provide actionable insights for improving Medicaid managed care enrollment and assignment.

Main Methods:

Analysis of education, enrollment, and assignment processes in seven states with mandatory Medicaid managed care.
Case study approach examining specific state experiences (e.g., Minnesota, Oregon).

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Main Results:

A majority of enrollees select their own health plan when the system is designed to support choice.
Effective strategies include aligning program design with state priorities, coordinating enrollment/eligibility, and providing educational resources.
Personalized attention and robust state contracting processes enhance choice and continuity of care.

Conclusions:

Explicitly designing Medicaid managed care systems to facilitate choice leads to high enrollee selection rates.
Key elements for success include streamlined processes, comprehensive education, and supportive contracting.
These findings offer a roadmap for states to optimize their managed care programs.