Medicaid Managed Care Payment Policies to Support Pediatric Providers

 

By Cindy Mann, Partner, Manatt Health | Andy Schneider, Research Professor of the Practice, Georgetown University Center for Children and Families

What Actions Can State Medicaid Agencies and Medicaid Managed Care Organizations Take to Support Financial Stability for Pediatric and Other Primary Care Practices During the COVID-19 Pandemic? Find Out in a New Webinar From the American Academy of Pediatrics, the Georgetown University Center for Children and Families, Family Voices, and Manatt Health. Click Here to Register for Free.

In 39 states plus the District of Columbia, most Medicaid-eligible children are enrolled in a Medicaid managed care organization (MCO) that provides payment to providers for the services they deliver to children and other MCO members. Since the start of the COVID-19 pandemic, those providers—particularly pediatric and primary care providers—have come under enormous financial pressure. The number of routine visits, such as well-child visits, dropped sharply as parents observed social distancing and stay-at-home recommendations. At the same time as MCO payments to network providers have declined due to decreased utilization, MCOs have continued to receive payments from states based on their number of members and historic levels of utilization.

In a new webinar, the American Academy of Pediatrics, the Georgetown University Center for Children and Families, Family Voices and Manatt Health will review the legal requirements and policy considerations that govern state contracts with MCOs and what they mean for pediatric and primary care providers during COVID-19. We also will explore strategies states and MCOs can take to support financial stability for pediatric and other primary care providers, including:

  • Directing MCO payments to network providers furnishing pediatric primary care services to make up for lost revenue resulting from the pandemic
  • Creating incentives for MCOs and network providers to negotiate alternative reimbursement arrangements​
  • Leveraging information to assess utilization, the status of the primary care network, and MCO financial performance

Even if you can’t make our original airing on December 7, click here to register for free now, and you’ll receive a link to view the program on demand.

This webinar is funded through the generous support of the Robert Wood Johnson Foundation, the Lucile Packard Foundation for Children’s Health, the David and Lucile Packard Foundation, and the Annie E. Casey Foundation.

Presenters:
Cindy Mann, Partner, Manatt Health
Andy Schneider, Research Professor of the Practice, Georgetown University Center for Children and Families

Date and Time
Monday, December 7, 2020
3:30 – 4:30 p.m. ET

RSVP
Click here to register for free.

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If you would like to receive an audio transcript of this webinar due to accessibility issues, please email us at webinars@manatt.com.

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