In this section, you will find managed care laws and rules, the latest research in digestible bites, and who to call when you’re in the next phase of your managed care contract negotiation.
Key Resources Links
Regulatory Requirements and Resources
-
Medicare Advantage Penetration Information by County and State
-
Center for Medicare and Medicaid Innovation
-
Find CMMI Models in Your State
-
Medicare Accountable Care Organizations
-
Bundled Payment for Care Improvement Advanced
-
Comprehensive Care for Joint Replacement Bundled Payment
-
Integrated Care Resource Center
-
Center for Health Strategies
-
ACO REACH
Key Federal Explanations and Regulations on Medicare Advantage
Medicare Advantage Plan Information
Federal Medicaid Managed Care Resources
- US Government Medicaid Managed Care Information
- Overview of Medicaid Managed Care
- Reference Guide to Federal Medicaid Statutes and Regulations
- Federal Regulations on Managed Care – Title 42, Part 428 of the Federal Code of Regulations
- State Managed Care Profiles and Data Collections
- Managed Care Organization HIE Policy
State Medicaid Managed Care Resources
-
Arizona: https://www.azahcccs.gov
-
Arkansas: https://medicaid.mmis.arkansas.gov
-
Connecticut: https://www.ct.gov/oha/cwp/view.asp?a=4363&q=520616
-
Georgia: https://dch.georgia.gov/medicaid
-
Kansas: https://www.kancare.ks.gov
-
Louisiana: http://ldh.la.gov/index.cfm/page/220
-
Massachusetts: https://www.mass.gov/topics/masshealth
-
Minnesota:
-
Mississippi: https://medicaid.ms.gov/programs/managed-care/
-
Missouri: https://dss.mo.gov/mhd/mc/
-
New Hampshire: https://www.dhhs.nh.gov/ombp/caremgt/index.htm
-
Oklahoma (N/A): http://www.okhca.org/individuals.aspx?id=94&menu=42
-
Pennsylvania: http://www.healthchoices.pa.gov/info/about/
-
South Dakota: https://dss.sd.gov/medicaid/providers/programinfo/mcare/
-
Virginia: http://www.dmas.virginia.gov/#/index