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Critical Questions Remain Unanswered in Medicaid Managed Care Contract

stethoscope and pen with medical charts

While managed care holds the promise both to improve the quality of care Medicaid members receive and to reduce the costs the state incurs in administering the program, numerous questions associated with the contract must be answered in order for New Hampshire to achieve those goals. This Issue Brief does not offer a comprehensive list of such questions, but instead focuses on two areas: ensuring access to care for Medicaid members and assessing the effectiveness of managed care over time.

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Key Questions to Consider in Implementing Medicaid Managed Care in New Hampshire

September 21, 2011 Health Policy, Research, State Budget
stethoscope and pen with medical charts

New Hampshire’s legislature approved changes to the state’s Medicaid program that require the development of a managed care system. This holds promise for reducing costs and even improving care, but New Hampshire’s previous experiences with managed care and those of other states suggest this may not be easy. Potential savings may be modest and take time to materialize. This Issue Brief identifies some of the pitfalls New Hampshire may face when it comes to implementing a risk-based managed care system for Medicaid patients.

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Federal Budget Plans Would Shift Medicaid Costs to New Hampshire

May 26, 2011 Health Policy
US Capitol

As many as 165,000 New Hampshire residents relied on Medicaid in fiscal year 2010. The program provides long-term care to seniors, helps residents with disabilities live independently, and enables children to see a doctor when they are sick or injured. Since 1965, the program has functioned as a partnership between the state and the federal government, guaranteeing coverage for qualified recipients and providing federal funds to cover a fixed percentage of the costs.

Yet, several federal budget proposals would fundamentally recast that partnership, converting Medicaid into a block grant program, limiting federal contributions and dropping the guarantee of coverage for those who are deemed eligible.

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Work Requirement Implementation Begins Amid Troubling Signs from Other States

4 Mar 2019

tree with coins

Implementation of the work and community engagement requirements for Medicaid expansion enrollees officially began March 1, with June as the first month requiring non-exempt enrollees to have 100 hours of qualifying activities. The flexibility within New Hampshire’s current rules permits enrollees to use a subsequent month to fulfill their required hours, and certain individuals are exempt from the requirements; however, individuals could lose health care coverage for not fulfilling the work and community engagement reporting requirements as early as August.