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- August 19, 2014
Managed Care in CA Series, Issue 1: Network Adequacy Laws (Revised May 7, 2018)
Read moreManaged Care and California Series Issue 1: Medi-Cal managed care plans are capitated, meaning. they receive a set payment per enrollee per month in exchange for providing services. The plans contract on a "comprehensive risk" basis, which means they accept the risk of incurring a loss if they spend…
- August 19, 2014
Managed Care in California Series, Issue 2: Network Adequacy Laws in Covered California Plans
Read moreManaged Care and California Series Issue 2: Covered California QHPs receive a set premium payment ("capitation") per enrollee in exchange for providing services. The plans accept the risk of incurring a loss if they spend more on services than they receive through the premium payments, but they will make…
- August 18, 2014
Health Advocate: Alternative Benefit Plans
Read moreAlternative Benefit Plans (ABPs), formerly known as Medicaid benchmarks, have existed since the Deficit Reduction Act of 2005 gave states the authority to develop alternative Medicaid benefit packages for select groups of Medicaid beneficiaries. Prior to the Affordable Care Act (ACA) only a few states had selected this option.…
- August 4, 2014
Webinar: Burwell v. Hobby Lobby – Access to Care Implications
Read moreWebinar focused on the impact on access to care post the U.S. Supreme Court's decision in Burwell v. Hobby Lobby.