Managed care: Fear awaits

The White House Office of Management and Budget review has passed an ambitious new policy that could radically overhaul the Medicaid managed care system.

The OMB action paved the way for the Centers for Medicare & Medicaid Services to soon issue a final rule, stakeholders agreed.

The plan, which was first announced in the fall of 2014, would align Medicaid Managed Care regulations with existing commercial, Marketplace, and Medicare Advantage regulations. Some regulators are calling for a dramatic revision because it has been more than 13 years since the regulations have been updated.

Providers have welcomed updates but also asked CMS to tread lightly. An American Health Care Association report called the rise of managed care and seniors a “risky business with challenges and uncertainties for all parties.” 

“Research to date suggests that implementing managed LTSS [Long Term Services and Supports] programs poses different challenges than overseeing existing managed acute care programs,” AHCA authors wrote in the analysis “Future Spending Fears Spur Managed Care for Adults.”

More than 42 million Americans are currently enrolled in some form of Medicaid managed care, according to a Henry J. Kaiser Family Foundation report.