Question

Discuss the current status of Medicaid Managed Care in South Carolina. What are the benefits and challenges faced by this State and why? How is the state capitalizing on the benefits and how are they mitigating or responding to challenges? If your state does not participate, choose a state to discuss that does. Please include references

Answer 1

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EXPLANATION:

I work for the Department of Health Care Services in South California, promoting Medicare, Medi-Cal, the nation's largest system offering care to over 13 million beneficiaries. South California became the first state in the early 1970s to enter into liability arrangements with managed care programs to support Medicaid patients, rather than charging for facilities on a fee-for - service basis (FFS). Medi-Cal started moving more patients into managed care over the past few decades. More than three-quarters of all Medi-Cal recipients, including children with low incomes, teenagers, seniors and people with disabilities, are now enrolled in managed care programs.

One of South California's greatest obstacles is the sheer scale and complexity of the operation, we've worked hard to modernize our obsolete computer systems to sustain this huge program. This was not an straightforward project and there were a lot of drawbacks to it. South California's changing health-care climate and complex dynamics make this very difficult. At the other hand, our state's size also offers advantages because we have a greater healthcare budget than smaller states do.

Reference:

Medi-Cal Payment to Managed Care Plans: Current Process and Challenges

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