MCD 301- Lesson 1: What is Medicaid managed care? Quiz

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  1. MCO members are surveyed to provide feedback on:1
  2. Health Effectiveness Date and Information Sets (HEDIS) measure Medicaid populations for care related to:1
  3. Not all states have the same standards regarding provider network availability within adequate distance and time from the member1
  4. Managed Care in the Medicaid space is referred to as an “at risk” operation.1
  5. Data shows physician concerns related to managed care include:1
  6. After processing a claim, an MCO usually sends a record to the state referred to as1
  7. Provider rates for services are negotiated by states, and then MCOs have to pay those rates to providers.1
  8. Medical Loss Ratio or MLR is the amount of profit makes, usually about 15%.1
  9. Managed care is a term that is uniquely used in the Medicaid space for Medicaid at risk health insurance operators.1
  10. Medicaid MCOs can make up to 50% profit in most states.1
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