tci Medicare Compliance & Reimbursement - 2005 Issue 8

Health Plans: 3 Biggest Challenges To Winning At Medicaid

Plan for these hurdles in advance to assure successA growing number of governors - such as Georgia Gov. Sonny Perdue (R) and Florida Gov. Jeb Bush (R) - are looking to managed care plans to save their Medicaid programs. That doesn't mean it'll be an easy job for health plans. Here's what to look for:1. Tough population. "Medicaid populations frequently have different needs than the commercial populations," says Jim Verdier of Mathematica Policy Research Institute. In Medicaid, a higher proportion of the more costly population is pregnant. Some of the young children can be fairly expensive as well...

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