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Amerigroup is an American health insurance and managed health care provider. Amerigroup covers 7.7 million seniors, people with disabilities, low-income families and other state and federally sponsored beneficiaries, and federal employees in 26 states, making it the nation's largest provider of health care for public programs. [1]
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
States can make managed care enrollment voluntary, or seek a waiver from CMS to require certain populations to enroll in an MCO. If states provide a choice of at least two plans, they can mandate enrollment in managed care. Healthy children and families make up the majority of Medicaid managed care enrollees, but an increasing number of states ...
Jul. 5—Mercy Health and Anthem Blue Cross and Blue Shield have agreed to a 90-day transition period for Anthem Medicaid members after rate negotiations stalled last week, an Anthem spokesperson ...
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
The Medicare Shared Savings Program (MSSP) was established by section 3022 of the Affordable Care Act. It is the program by which an accountable care organization interacts with the federal government, and by which accountable care organizations can be created. [109] It is a fee-for-service model.
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