Improving the quality and cost-effectiveness of publicly financed health care
Negotiating the New Health System at Ten: Medicaid Managed Care and the Use of Disease Management Purchasing
Between 1997 and 2002, the George Washington University School of Public Health and Health Services (GWU) published Negotiating the New Health System: A Nationwide Study of Medicaid Managed Care Contracts. This first national analysis of Medicaid managed care contracts offered critical insights into how state purchasing practices help shape health care access, quality, and accountability for Medicaid beneficiaries.
This new Negotiating the New Health System study takes a close look at the role of disease management in Medicaid purchasing in 10 states. It examines how these states are purchasing disease management (DM) services, through either special DM contracts or as part of broader Medicaid purchasing agreements. The report outlines similarities and variations across states, provides sample contract language, and offers takeaway lessons for states developing disease management contracts.