{"title":"医疗补助管理医疗改革的挑战。","authors":"Jane McCahill, Joseph T Van Leer","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>This article explores the specific consequences to states as a result of expansion of the Medicaid program under PPACA. Jane McCahill and Joseph Van Leer explain the history of the Medicaid program, comparing and contrasting Medicaid pre-PPACA with Medicaid post-PPACA. The authors examine the use of managed care models by state Medicaid programs, describing the various forms of Medicaid managed care employed by the states. The authors then detail the significant changes resulting to Medicaid under PPACA. Finally, the article reviews the Medicaid managed care program in Illinois specifically, focusing on reform of the Illinois Medicaid program to be effectuated over the next few years. The authors conclude by recommending mechanisms for integration among providers under the managed care model in order to contain costs and achieve increased quality of care.</p>","PeriodicalId":79788,"journal":{"name":"Annals of health law","volume":"21 3","pages":"541-59, i"},"PeriodicalIF":0.0000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The challenges of reform for Medicaid managed care.\",\"authors\":\"Jane McCahill, Joseph T Van Leer\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This article explores the specific consequences to states as a result of expansion of the Medicaid program under PPACA. Jane McCahill and Joseph Van Leer explain the history of the Medicaid program, comparing and contrasting Medicaid pre-PPACA with Medicaid post-PPACA. The authors examine the use of managed care models by state Medicaid programs, describing the various forms of Medicaid managed care employed by the states. The authors then detail the significant changes resulting to Medicaid under PPACA. Finally, the article reviews the Medicaid managed care program in Illinois specifically, focusing on reform of the Illinois Medicaid program to be effectuated over the next few years. The authors conclude by recommending mechanisms for integration among providers under the managed care model in order to contain costs and achieve increased quality of care.</p>\",\"PeriodicalId\":79788,\"journal\":{\"name\":\"Annals of health law\",\"volume\":\"21 3\",\"pages\":\"541-59, i\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2012-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of health law\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of health law","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
本文探讨了PPACA下扩大医疗补助计划对各州的具体后果。Jane McCahill和Joseph Van Leer解释了医疗补助计划的历史,比较和对比了ppaca之前的医疗补助计划和ppaca之后的医疗补助计划。作者研究了国家医疗补助计划管理医疗模式的使用,描述了各州采用的医疗补助管理医疗的各种形式。然后,作者详细介绍了PPACA下医疗补助的重大变化。最后,本文具体回顾了伊利诺伊州的医疗补助管理式医疗计划,重点关注未来几年伊利诺伊州医疗补助计划的改革。作者最后推荐了在管理式医疗模式下整合提供者的机制,以控制成本并提高医疗质量。
The challenges of reform for Medicaid managed care.
This article explores the specific consequences to states as a result of expansion of the Medicaid program under PPACA. Jane McCahill and Joseph Van Leer explain the history of the Medicaid program, comparing and contrasting Medicaid pre-PPACA with Medicaid post-PPACA. The authors examine the use of managed care models by state Medicaid programs, describing the various forms of Medicaid managed care employed by the states. The authors then detail the significant changes resulting to Medicaid under PPACA. Finally, the article reviews the Medicaid managed care program in Illinois specifically, focusing on reform of the Illinois Medicaid program to be effectuated over the next few years. The authors conclude by recommending mechanisms for integration among providers under the managed care model in order to contain costs and achieve increased quality of care.