Network Adequacy in Managed Care

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December 2018

The use of managed care shifts responsibility and accountability from states to managed care organizations. It also allows states to limit access to a network of providers under contract to a managed care organization.  This session discusses oversight of network adequacy and access to care, and how states and the federal government document, monitor, and enforce program standards.

This presentation includes information on managed care network oversight based on a review of publicly available information from 14 state Medicaid programs, including state quality strategies, managed care contracts, and network adequacy standards.

Publication Type: Presentations

From: December 2018 MACPAC Public Meeting

Tags: consumer protections, full risk managed care, managed care, network adequacy, oversight