Matches in SemOpenAlex for { <https://semopenalex.org/work/W2473102710> ?p ?o ?g. }
Showing items 1 to 90 of
90
with 100 items per page.
- W2473102710 abstract "The rapid transition of state Medicaid beneficiaries into fully capitated managed care plans requires a special focus on children with chronic or disabling conditions, who often depend on numerous pediatric physicians and other specialty services for health care and related services. Because managed care arrangements for this population are growing in popularity nationwide, it is important that states craft managed care contracts to address the unique needs of children with complex physical, developmental, and mental health problems. Based on the research reported in this article, in-depth interviews with state Medicaid agency staff, interviews with medical directors and administrators of managed care plans serving Medicaid recipients, and input from experts in pediatrics and managed care, a set of recommendations is made for tailoring managed care contracts to meet the needs of this vulnerable group of children. Six contracting elements that should be adopted by state Medicaid agencies include (1) clarifying the specificity of pediatric benefits, (2) defining appropriate pediatric provider capacity requirements, (3) developing a medical necessity standard specific to children, (4) identifying pediatric quality-of-care measures, (5) setting appropriate pediatric capitation rates, and (6) creating incentives for high-quality pediatric care. Nine approaches that should be adopted by managed care practices interested in providing high-quality care for children with special needs also are identified. These include (1) ensuring that assigned primary care providers have appropriate training and experience, (2) offering support systems for primary care practices, (3) providing specialty consultation for primary care providers, (4) establishing arrangements for the comanagement of primary and specialty pediatric services, (5) arranging for comprehensive care coordination, (6) establishing flexible service authorization policies, (7) implementing provider profiling systems that adjust for pediatric case mix, (8) creating financial incentives for serving children with special needs, and (9) encouraging family involvement in plan operations. Implementing these changes to managed care contracting could have a major impact on the quality and comprehensiveness of health care received by children with special needs. Successful implementation, however, requires strong support from both state Medicaid agencies and the managed care plans dedicated to serving this population." @default.
- W2473102710 created "2016-07-22" @default.
- W2473102710 creator A5075734448 @default.
- W2473102710 creator A5087897098 @default.
- W2473102710 date "2016-01-01" @default.
- W2473102710 modified "2023-09-26" @default.
- W2473102710 title "Improving State Medicaid Contracts and Plan Practices for Children with" @default.
- W2473102710 cites W1579370012 @default.
- W2473102710 cites W201364804 @default.
- W2473102710 cites W2047704538 @default.
- W2473102710 hasPublicationYear "2016" @default.
- W2473102710 type Work @default.
- W2473102710 sameAs 2473102710 @default.
- W2473102710 citedByCount "0" @default.
- W2473102710 crossrefType "journal-article" @default.
- W2473102710 hasAuthorship W2473102710A5075734448 @default.
- W2473102710 hasAuthorship W2473102710A5087897098 @default.
- W2473102710 hasConcept C10138342 @default.
- W2473102710 hasConcept C108170787 @default.
- W2473102710 hasConcept C111472728 @default.
- W2473102710 hasConcept C138885662 @default.
- W2473102710 hasConcept C144133560 @default.
- W2473102710 hasConcept C145097563 @default.
- W2473102710 hasConcept C159110408 @default.
- W2473102710 hasConcept C160735492 @default.
- W2473102710 hasConcept C162324750 @default.
- W2473102710 hasConcept C175444787 @default.
- W2473102710 hasConcept C20387591 @default.
- W2473102710 hasConcept C2776196091 @default.
- W2473102710 hasConcept C2776534028 @default.
- W2473102710 hasConcept C2777369334 @default.
- W2473102710 hasConcept C2778804116 @default.
- W2473102710 hasConcept C2780265253 @default.
- W2473102710 hasConcept C2908647359 @default.
- W2473102710 hasConcept C29122968 @default.
- W2473102710 hasConcept C2984752397 @default.
- W2473102710 hasConcept C50522688 @default.
- W2473102710 hasConcept C512399662 @default.
- W2473102710 hasConcept C71924100 @default.
- W2473102710 hasConcept C99454951 @default.
- W2473102710 hasConceptScore W2473102710C10138342 @default.
- W2473102710 hasConceptScore W2473102710C108170787 @default.
- W2473102710 hasConceptScore W2473102710C111472728 @default.
- W2473102710 hasConceptScore W2473102710C138885662 @default.
- W2473102710 hasConceptScore W2473102710C144133560 @default.
- W2473102710 hasConceptScore W2473102710C145097563 @default.
- W2473102710 hasConceptScore W2473102710C159110408 @default.
- W2473102710 hasConceptScore W2473102710C160735492 @default.
- W2473102710 hasConceptScore W2473102710C162324750 @default.
- W2473102710 hasConceptScore W2473102710C175444787 @default.
- W2473102710 hasConceptScore W2473102710C20387591 @default.
- W2473102710 hasConceptScore W2473102710C2776196091 @default.
- W2473102710 hasConceptScore W2473102710C2776534028 @default.
- W2473102710 hasConceptScore W2473102710C2777369334 @default.
- W2473102710 hasConceptScore W2473102710C2778804116 @default.
- W2473102710 hasConceptScore W2473102710C2780265253 @default.
- W2473102710 hasConceptScore W2473102710C2908647359 @default.
- W2473102710 hasConceptScore W2473102710C29122968 @default.
- W2473102710 hasConceptScore W2473102710C2984752397 @default.
- W2473102710 hasConceptScore W2473102710C50522688 @default.
- W2473102710 hasConceptScore W2473102710C512399662 @default.
- W2473102710 hasConceptScore W2473102710C71924100 @default.
- W2473102710 hasConceptScore W2473102710C99454951 @default.
- W2473102710 hasLocation W24731027101 @default.
- W2473102710 hasOpenAccess W2473102710 @default.
- W2473102710 hasPrimaryLocation W24731027101 @default.
- W2473102710 hasRelatedWork W1505213795 @default.
- W2473102710 hasRelatedWork W1663287886 @default.
- W2473102710 hasRelatedWork W1834153739 @default.
- W2473102710 hasRelatedWork W19125807 @default.
- W2473102710 hasRelatedWork W2000745045 @default.
- W2473102710 hasRelatedWork W2001907200 @default.
- W2473102710 hasRelatedWork W2119746177 @default.
- W2473102710 hasRelatedWork W2143948749 @default.
- W2473102710 hasRelatedWork W2318563493 @default.
- W2473102710 hasRelatedWork W2324162801 @default.
- W2473102710 hasRelatedWork W2332797742 @default.
- W2473102710 hasRelatedWork W2405333709 @default.
- W2473102710 hasRelatedWork W2416420920 @default.
- W2473102710 hasRelatedWork W2417473066 @default.
- W2473102710 hasRelatedWork W2427799627 @default.
- W2473102710 hasRelatedWork W2621831235 @default.
- W2473102710 hasRelatedWork W3144231666 @default.
- W2473102710 hasRelatedWork W3147619130 @default.
- W2473102710 hasRelatedWork W3149434191 @default.
- W2473102710 hasRelatedWork W3170175859 @default.
- W2473102710 isParatext "false" @default.
- W2473102710 isRetracted "false" @default.
- W2473102710 magId "2473102710" @default.
- W2473102710 workType "article" @default.