The Kaiser-HCEA State Symposia Series Transitioning to Medicaid Managed Care Consumer Protection: Lessons Learned From States

As states transition their Medicaid programs into a sometimes chaotic and always fast moving managed care marketplace, careful consideration is required to protect Medicaid beneficiaries and assure them access to quality care. Based upon a day-long discussion with state officials, this paper summarizes how states are developing those consumer protections through enrollment and disenrollment systems, strategies to involve consumers, outreach and education activities, and complaint and grievance procedures. It was the intention of this work to focus only on those activities-—and not the broader responsibilities of states in monitoring managed care—in order to elucidate lessons learned. This paper, then, is a brief synthesis of selected state practices and a practical checklist of lessons learned. We hope the paper will help other states further advance innovative approaches to reaching and enrolling Medicaid beneficiaries in managed care which best serves their needs.

1996.Dec_.kaiser.hcfa_.medicaid.managed.care_.consumer.protection.pdf

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