The challenges of reform for Medicaid managed care.

Abstract

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.