Managed care for Medicaid moves to center stage

Article Abstract:

Pennsylvania is phasing in managed care for its Medicaid recipients, starting with the Philadelphia area's low-income Medicaid population. Consumers and healthcare providers see both risk and opportunity in the state plan. Physicians will welcome the phase-in, according to the Pennsylvania Medical Society's Donald N. McCoy, because Medicaid reimbursements look relatively generous to doctors who have seen payments from other sources decline substantially.

HEALTH SERVICES, Direct Health and Medical Insurance Carriers, Administration of Public Health Programs, Health Care Services, Health Programs-State, Health Plan Administration, Management, Usage, Medical care, Social policy, Managed care plans (Medical care), Health policy, Pennsylvania, Medicaid, Health insurance industry

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Split reaction on GAO review of practice expense change

Article Abstract:

Specialty physicians are disputing data used in finding proposed practice expense values. A report by the General Accounting Office showed that payments for hospital-centered and procedure-based specialties would be reduced significantly, but payments to primary care physicians may increase. The GAO may perform on-site reviews to validate the proposed values.

Research, Medicine, United States. Government Accountability Office, Medical specialties

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