State Interagency Collaboration: Assuring Quality Care for Mothers and Children in Medicaid Risk-Based Managed Care
Many agencies at the State level have regulatory authority over managed care plans operating in the private and public sectors. How can those agencies better coordinate, eliminate duplication, reduce administrative cost and improve quality of care?
Several factors suggest a need for improved interagency collaboration: more and more health plans are (or will be) enrolling both a Medicaid and a commercial population and therefore are subject to multiple sets of State regulations and rules, Medicaid managed care expansion (whether or not linked to private sector health plans with commercial enrollment) may require that Medicaid agencies look to others for resources and expertise to design and manage a new and complicated component of program operations. Clearly health plans and consumers have a stake in State interagency collaboration efforts. While the focus of this paper remains on Medicaid and regulatory agencies, this is discussed throughout the paper.