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Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
A variety of different types of health plans serve Medicaid managed care programs, including for-profit and not-for-profit, Medicaid-focused and commercial, independent and owned by health care providers such as community health centers. In 2007, 350 health plans offered Medicaid coverage.
MDVIP is an American company, headquartered in Boca Raton, Florida, that operates a network of physicians. The company's physicians practice preventive medicine and personalized primary-care medicine. The national network consists of 1,100 physicians serving over 380,000 patients in 45 states and the District of Columbia. [1]
The report found that 8 in 10 calls to Florida's Medicaid call center were automatically disconnected from the phone system. When people managed to get through, there were long delays to reach ...
The Florida Agency for Health Care Administration (AHCA) is the chief health policy and planning entity for the U.S. state of Florida. The agency was created by the Florida Legislature as part of the Health Care Reform Act of 1992. [ 1 ]
The amount of involvement an insurer can have in managing high cost cases depends on the structure of the benefit plan. In a tightly managed plan case management may be integral to the benefits program. In less tightly managed plan, participation in a case management program is often voluntary for patients. [5]
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Introduced for Medicaid in 1989 and Medicare in 1990, this designation allowed HRSA-funded health centers to receive cost-based reimbursement rates. Covered services included those provided by physicians, physician assistants, nurse practitioners, certified nurse midwives, clinical psychologists, and clinical social workers.