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The Pulse

  • Medicaid Managed Care Tools and Resources

    The Department of Health and Human Services has created some tools and resources to transition Medicaid providers, and to help patients who are moving to Medicaid Managed Care:

    • New Provider Playbook. DHHS has launched an online “Provider Playbook” to ensure you have at your fingertips the latest information on managed care, including communications and materials provided to your patients. The Provider Playbook combines new resources, such as a beneficiary enrollment experience paper and managed care fact sheets (attached) with the existing training, forums and virtual office hours already in place to support providers.
    • New Provider Issues and Resolutions Overview. Raising issues as they are encountered allows for prompt research and implementation of improvements that have an immediate effect on the provider and beneficiary experience. It is also important to share the situations and their resolution broadly for other providers to anticipate potential needs in their own practices. Attached is the first Provider Issues and Resolutions Overview that describes the issue, its resolution and next steps. Naturally, there will be times when mitigating circumstances may affect the outcome. In those cases, the Overview includes a “Know” section that provides you with background information and additional considerations.
    • New Provider Calls Start August 13. The complex transition to managed care requires regularly scheduled and ongoing interaction between providers, stakeholders and DHHS to quickly identify, discuss and solve issues and concerns. For example, there are times when it is more effective to ask questions and get answers from Medicaid leadership and experts on specific topics rather than receive a written update. Starting Tuesday, August 13, Medicaid will hold calls with provider associations where association leadership will hear an update on the progress to launch Medicaid Managed Care, an overview of provider-related issues and how they are being addressed, and other information specific to the provider community. This will be an interactive call with time reserved for questions and answers. Calls will initially occur with provider associations. We will add open calls for all providers and other stakeholders in the weeks that follow. Look for details to arrive shortly.
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