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Medicaid: Factors to Consider in Managed Care Programs

T-HRD-92-43 Published: Jun 29, 1992. Publicly Released: Jun 29, 1992.
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Highlights

GAO discussed the role of managed care in state Medicaid programs. GAO noted that: (1) adequate safeguards and oversight are crucial to the success of managed care programs; (2) it has previously identified problems with access to care, quality of services, and oversight of providers' financial reporting and solvency; (3) the Oregon program does not place excessive financial risk on providers, since Oregon has safeguards in place to prevent inappropriate reductions in service delivery or quality; and (4) before expanding its program, Oregon should meet Medicaid ownership disclosure requirements, from which it is currently exempt, and improve its monitoring of providers' financial solvency.

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Financial managementHealth care cost controlHealth insurance cost controlHealth maintenance organizationsInternal controlsManaged health careQuality assuranceReporting requirementsState-administered programsMedicaid