United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1996-09-17 monographic deposited born digital 36 p. GA 1.13:HEHS-96-184 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-184 P0b002ee1803a3cf2 f:he96184 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-96-184 machine generated eng fdlp REPORT GAOREPORTS-HEHS-96-184 HEHS-96-184 Managed health care Health resources utilization State-administered programs Health maintenance organizations Health services administration Health insurance cost control Program abuses Information dissemination operations Beneficiaries Health care programs Medicaid Program Washington Missouri Ohio Minnesota Letter Report HEHS Pursuant to a congressional request, GAO provided information on state efforts to enroll Medicaid beneficiaries in managed care, focusing on: (1) the role of managed care organizations (MCO) in marketing and expanding managed care participation; (2) the types of marketing and enrollment abuses that have occurred and states' efforts to curb these abuses and ensure that beneficiaries are informed about their health plan options; and (3) state efforts to measure the effectiveness of their education and enrollment approaches.<p/>GAO found that: (1) some states have allowed MCO to use various direct-marketing strategies to boost enrollment in Medicaid managed care programs; (2) because some MCO and their agents have engaged in unscrupulous and illegal practices to enroll Medicaid beneficiaries and maximize their revenues and commissions, many states have banned or restricted MCO activities; (3) Minnesota, Ohio, Washington, and Missouri have effectively controlled their enrollment programs by banning direct-marketing activities and retaining enrollment responsibilities; (4) these states devote considerable resources to educating Medicaid beneficiaries on managed care so their transition from fee-for-service care is easier; (5) each of these states' educational approaches varies because of their differing circumstances and program goals; (6) these states use public employees to provide in-person education and counseling, independent contractors or enrollment brokers, and telephone and direct mail strategies to promote better understanding of the program; (7) state education and enrollment efforts are often enhanced by community group and MCO education activities; (8) although community groups in these states believe that education and enrollment efforts have helped Medicaid beneficiaries' transition to managed care, the effectiveness of these approaches has not been adequately measured; (9) state officials and experts believe that the best measure of effectiveness is the rate which beneficiaries select their own health plan; and (10) most states voluntary selection rates range from 59 to 88 percent. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-184/html/GAOREPORTS-HEHS-96-184.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-184/pdf/GAOREPORTS-HEHS-96-184.pdf GAO/HEHS-96-184 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-184 Letter Report GAO/HEHS-96-184; Medicaid: States' Efforts to Educate and Enroll Beneficiaries in Managed Care; Managed health care Health resources utilization State-administered programs Health maintenance organizations Health services administration Health insurance cost control Program abuses Information dissemination operations Beneficiaries Health care programs Medicaid Program Washington Missouri Ohio Minnesota