Managed Care

Managed care is increasingly used by states to finance and deliver care for Medicaid beneficiaries with complex health and behavioral health care needs as a means to enhance care coordination, improve outcomes, and control costs. This can be particularly important for high-cost, high-need individuals such as those with frequent hospital emergency department visits or hospital admissions, and people experiencing homelessness.

A doctor explains results to a patient, showing him something on a computer tablet

TAC assists public purchasers to design prudent purchasing and performance-based contracts, helping to inform decisions that maximize available services to meet beneficiaries’ needs; manage costs and utilization; and enhance quality. TAC also guides purchasers in identifying necessary infrastructure and competencies required of their provider networks to meet the demands of the ever-changing behavioral health care landscape.

Areas of Expertise

  • Medicaid managed care plans that support delivery of a full continuum of mental health and substance use disorder services
  • Procurement processes and requests for proposals to select managed care or administrative service organizations
  • Service performance standards and utilization management, quality improvement, and compliance monitoring strategies within a managed care environment
  • Care management and integrated care approaches, and improving related outcomes
  • Social determinants of health, including managed care plans to provide housing-related supports and opportunities
Group 4