Thursday, August 22, 10:00 am – 11:30 am
Issued in May 2016, the Medicaid and CHIP managed care final rule was the first significant update to the programs’ managed care regulations since 2003. Provisions in the regulation aim to improve beneficiary experience, enhance quality improvement activities, and increase transparency, including the requirement that CMS establish a Quality Rating System (QRS). The regulation requires states to implement either CMS-developed QRS or a substantially comparable alternative. In this listening session, CMS will share its QRS policy objectives and solicit feedback from state CHIP officials who are encouraged to provide input on ways to maximize the usability of QRSs to beneficiaries and health plans from their unique CHIP perspectives.
States are increasingly using managed care to deliver services to children with complex health needs enrolled in Medicaid. This roundtable discussion features the work of two states that have made innovative efforts in this area. Participants will have an opportunity to raise questions and discuss opportunities and challenges to improving care quality and controlling costs for children with medical complexity in Medicaid managed care.