Medicaid In Healthcare

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Medicaid in the State of Illinois There are many healthcare systems throughout the world. The United States has a healthcare system based on insurance coverage both private and public. One of the public healthcare systems is Medicaid. Medicaid is managed by the States and therefore varies State to State. Today, we will explore Medicaid in the state of Illinois (IL) looking at the enrollment rate in IL compared to the national average, the different Medicaid plans offered and how many people utilize each plan, and how the payment systems work both for the beneficiaries’ cost and for the reimbursement to providers and the healthcare system. The total number of enrollees in Medicaid in the state of IL is 2,931,023 as of 2013. Out of 2,931,023…show more content…
This program is mandatory for most of IL’s Medicaid’s participants. The Care Coordination Entities (CCE) governs the IHC. The CCEs is a group of providers and government agencies that ensure the patients’ care from the providers and medical facilities matches the payment provided. The PCCM has to meet the standards in order to receive payment (Medicaid Managed Care Enrollment Report, N.d.). According to web site, as of July 1, 2013 the following information was found about the enrollment in Medicaid for the state of IL and the United States. The MCO plan had about 282,183 people enrolled in 2013 that is 9.6 percent of the Medicaid population. The IHC had 1,870,271 enrolled throughout the state in 2013, which is 64 percent of the Medicaid eligible population. Making the total population in the Medicaid Managed Care plan in IL at about 74 percent of the Medicaid eligible population (Medicaid Managed Care Enrollment Report,…show more content…
Payments were provided by Medicaid or from the federal government through the Federal Medical Assistance Percentage (FMAP). The FMAP assists is between 50% and 75% with an average of about 57% of the states cost for each three-year cycle. The services provided by the Medicaid Managed Care plans have to be high quality and the pay is designed to keep the cost down by use of agreements with the providers to accept payment for services at about 70% of what is normally paid for the same care. The payment is paid on a monthly basses to the providers. Payments rates are updated using the Medicare Economic Index or a Medicaid–specific method. One of the ways the costs are kept down is the use of CCEs under the PCCM plan. For this plan the CCE manages the case of the patient and makes sure all the proper care is provided for a given patient, for example, test are not repeated by different providers, the patient needs to see instead the test results are shared by all personnel on the care team. The best way to accomplish this is through an electronic medical record shared by all the care teams. Another way to keep costs down is the incentive offered to the MCOs for accomplishing or beating the goals set by Medicare (Medicaid Managed Care Enrollment Report,

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