The Henry J. Kaiser Family Foundation and the federal Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services, through the National Academy for State Health Policy, convened this symposium as fourth in the series entitled T he Kaiser-HCFA State Symposia Series: Transitioning to Medicaid Managed Care. These symposia are designed to explore critical issues in building Medicaid managed care programs.
Held on May 12, 1998, “Transitioning to Medicaid Managed Care: Medicaid-Only MCOs” was attended by state and federal officials, consumer advocates, health plan representatives, managed care researchers and experts, and the Henry J. Kaiser Family Foundation and National Academy for State Health Policy staff.
The following states were represented: Colorado, Florida, Maine, Massachusetts, Minnesota, New Jersey, Oregon and Pennsylvania. Washington, D.C. participated as well.
The purpose of the roundtable was to examine the use of Medicaid-only MCOs in light of the provisions of the Balanced Budget Act which permit states increased flexibility to contract with Medicaid-only managed care organizations. The meeting sought to provide an open exchange to further examine state experiences with Medicaid-only plans, issues in the commercial marketplace, the concerns that Medicaid-only plans could lead to “Medicaid-mills” and strengths and weaknesses of these plans. In April 1998, an earlier draft of this paper was reviewed by the participants. This paper is not intended to provide a detailed explanation of individual state approaches, but to present and summarize the key issues developed in the meeting and the lessons learned by states from their work and programs thus far.