Medicaid: State Flexibility in Implementing Managed Care Programs
Requires Appropriate Oversight (Testimony, 07/12/95, GAO/T-HEHS-95-206).

Requiring states to obtain waivers to broaden use of managed care may
hamper their efforts to aggressively pursue cost-containment strategies.
At the same time, because current program restrictions on managed care
were designed to reinforce quality assurance, their absence requires the
substitution of appropriate and adequate mechanisms to protect both
Medicaid beneficiaries and federal dollars.  Finally, the reinvestment
of managed care savings to expand Medicaid coverage to several million
additional persons suggests the need for up-front consultation with
Congress because of (1) the heavier financial burden such 1115 waivers
may place on the federal government and (2) the issue of whether the
U.S. Treasury should benefit from those savings.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-95-206
     TITLE:  Medicaid: State Flexibility in Implementing Managed Care 
             Programs Requires Appropriate Oversight
      DATE:  07/12/95
   SUBJECT:  Federal funds
             Health care cost control
             Health maintenance organizations
             Beneficiaries
             Waivers
             Disadvantaged persons
             Quality assurance
             Oversight by Congress
             State-administered programs
IDENTIFIER:  Oregon Medicaid Managed Care Program
             Medicaid Program
             Arizona Medicaid Managed Care Program
             
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