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Fiscal Committee approves Medicaid managed-care incentive pool; officials say withhold funds drive quality
Summary
The Fiscal Committee on May 16 approved an incentive-pool mechanism in Medicaid managed-care contracts that built a roughly 2% adjustment into capitation rates as a performance pool for MCOs.
The Fiscal Committee on May 16 approved an incentive-pool mechanism in Medicaid managed-care contracts that built a roughly 2% adjustment into capitation rates as a performance pool for MCOs. State officials told the committee the pool is intended to motivate plans to meet higher quality and operational metrics.
The item, listed as 25126, was introduced by the Department of Health and Human Services. Henry Littman, the state's Medicaid director, described the structure during questions from committee members: "we have an agreement with Medicaid managed care organizations, and we pay them a monthly capitation rate. Built into that capitation rate is, approximately 2% ...…
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