Better Care, More Reimbursements

In Medicare and Medicaid services, managed care plans fall under Part C, a Medicare Advantage plan alternative to Parts A and B. Medicare Advantage plans often include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan.

Some states are implementing a range of initiatives to coordinate and integrate care beyond traditional managed care. These initiatives are focused on improving care for populations with chronic and complex conditions, aligning payment incentives with performance goals, and building accountability for high quality care.

Approximately 80% of Medicaid enrollees are served through managed care delivery systems.

Understanding the specifics can improve the beneficiary’s healthcare needs and provide ample reimbursement to providers. Therefore, it’s hugely important that you understand the need-to-know details of contracts, plan coverage, reimbursement rates, etc.

• Ins-and-outs of Medicare and Medicaid Managed Care Plans
• Plan Details and Coverage
• CMS Approval for All States Contracting With MCO or PIHP