Forefront: Advancing Equity For The Dually Eligible Population
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Monday, May 9, 2022 | The Latest Research, Commentary, And News From
Health Affairs
Dear John,
Health Affairs is hiring full-time, paid summer interns on our equity
and digital teams! Learn more about those opportunities on our website.
Applications are due May 12 .
Medicaid Managed Care Networks
Avital Ludomirsky and coauthors assess the level of Medicaid
participation among physicians
listed in the provider network directories of managed care plans.
Medicaid services have been increasingly outsourced by states to private
managed care plans.
Ludomirsky and coauthors examine data from four states across the period
2015-17 and determined more than a third of the physicians listed in
provider network directories for the plans treated ten or fewer Medicaid
beneficiaries in a year.
The authors provide policy suggestions based on their findings that
would improve the oversight of provider networks in state Medicaid
programs.
The authors state that relying on the physicians listed in Medicaid
managed care network directories to measure access is insufficient.
Instead, the authors suggest that enforcement of network adequacy
standards should evolve to ensure that plan networks are evaluated on
the basis of whether they include physicians who are both valued by
Medicaid beneficiaries and willing to treat them.
Ludomirsky will discuss this paper in greater detail at the next Health
Affairs event on May 17. Register today
.
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Elsewhere At Health Affairs
Today in Health Affairs Forefront, Karen Joynt Maddox and Kenton
Johnston discuss quality improvement efforts
that incorporate equity as a key priority.
The authors indicate that Medicare beneficiaries who are also eligible
for Medicaid (dual eligibles) have less access to high-quality care and
are more likely to have a disability.
Given these factors, the authors suggest that measuring cost and quality
of care is a critical step in determining payment models to improve
equity.
This article is the latest among a series in response to the latest
developments in policy and research affecting the dual-eligible
population. Other authors will contribute to the series as well.
The series is produced with the support of Arnold Ventures
. Included articles are reviewed and
edited by Health Affairs Forefront staff; the opinions expressed are
those of the authors.
The series will run through August 30, 2022; submissions are accepted on
a rolling basis.
Read More
Daily Digest
In Medicaid Managed Care Networks, Care Is Highly Concentrated Among A
Small Percentage Of Physicians
Avital B. Ludomirsky et al.
Advancing Equity For The Dually Eligible Population In Alternative
Payment Models
Karen E. Joynt Maddox and Kenton J. Johnston
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