The Value of Managed Care

Medicaid Managed Care provides real value for New Jersey.

Since the inception of the Medicaid Managed Care program in the 1990s, NJAHP’s Medicaid Managed Care Organizations (MCOs) have partnered with the State to improve access to health care for Medicaid/NJ FamilyCare beneficiaries and to effectively manage state Medicaid dollars. MCOs ensure quality and cost-effective care, in part, by emphasizing prevention and coordination of care. In addition, care and case management program ensure that beneficiaries have continuity of care and receive care that is appropriate for their condition. Our MCOs also currently provide additional services such as language translation services, community outreach programs, and health literacy and education programs to facilitate communication and access to care that are not routinely available via the Medicaid fee for service program. Medicaid health plans understand what Medicaid beneficiaries need to live healthier lives:

• Medicaid is a program with numerous challenges. In comparison to the general population, Medicaid beneficiaries have much higher rates of poor health, fewer resources, and lower rates of health literacy.

• Medicaid beneficiaries need integrated systems of care that promote access to necessary services and improve health outcomes.

• Medicaid beneficiaries benefit from outreach efforts that assist them in making and attending medical appointments and obtaining needed care on an ongoing basis.

• Medicaid beneficiaries with chronic conditions require focused programs that provide tailored clinical and care management strategies.

• Medicaid beneficiaries often benefit from assistance with non-health related needs that can improve their health and well-being.

NJAHP’s MCOs know this population and their needs well, and provide valuable services to meet these needs.