Since we first examined the managed care issue in 2015, a few important developments have occurred. In December 2015, the Health Reform Legislative Task Force released its preliminary report, and two models have been proposed to restructure the Medicaid program and create savings. In addition to a proposal to contract with managed care organizations, several Task Force members presented a plan called DiamondCare as an alternative to risk-based managed care. This plan recommends that another organization administer services for high costs and high needs populations in the Medicaid program, but without the financial risk that a managed care company assumes. A bill has been drafted for both an alternative model and the risk-based managed care model.

A patient and provider bill of rights is also outlined in the managed care bill that includes several protections to ensure families receive the services they need. It also focuses on ensuring providers are paid fairly for delivering high-quality services. While it’s too soon to tell what changes will be made as the bills are considered by lawmakers, it will be critical that a bill of rights to protect families from any reductions in access or quality of services be a key part of any health reform law. We won’t truly achieve reform until the health care system works for all children and families, especially our most vulnerable Arkansans.  

For more information about managed care in the Medicaid program, check out our previous analysis of the issue.