MCD 301- Lesson 1: What is Medicaid managed care? Quiz Please sign up for the course before taking this quiz. MCO members are surveyed to provide feedback on:1 Member experiences with plan representatives Patient experience with providers Member utilization levels of services Health Effectiveness Date and Information Sets (HEDIS) measure Medicaid populations for care related to:1 Well Child Visits Patient compliance Prenatal Care Cervical Cancer Childhood Immunization Not all states have the same standards regarding provider network availability within adequate distance and time from the member1 True False Managed Care in the Medicaid space is referred to as an “at risk” operation.1 True False Data shows physician concerns related to managed care include:1 Autonomy Quality of care Increased patient load Increased paperwork After processing a claim, an MCO usually sends a record to the state referred to as1 An encounter record A claim receipt A claim status Provider rates for services are negotiated by states, and then MCOs have to pay those rates to providers.1 True False Medical Loss Ratio or MLR is the amount of profit makes, usually about 15%.1 True False Managed care is a term that is uniquely used in the Medicaid space for Medicaid at risk health insurance operators.1 True False Medicaid MCOs can make up to 50% profit in most states.1 True False
