| Description |
1 online resource (105 pages) |
| Contents |
Cover -- Half Title -- Title Page -- Copyright Page -- Dedication -- Table of Contents -- Acknowledgmentsâ#x80;#x8A; -- Authorâ#x80;#x8A; -- Introduction -- 1: Building A Strong Foundation -- 1: Mission, Vision and Values -- Why Medicaid? -- Mission, Vision and Values: A State Perspective -- Mission, Vision and Values: A Health Plan Perspective -- Aligning State and Health Plan Perspectives -- A Word about Culture -- Summary of Key Points -- 2: Governance and Leadership -- The Importance of an Effective Board -- Key Governance Responsibilities |
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Hiring the Best LeadersAuthenticity -- Humility -- Integrity -- Transparency -- Who Should Be on Your Board? -- Summary of Key Points -- 3: Strategic Planning -- What Is an Effective Strategic Plan? -- Elements of a Strategic Plan -- Executing Strategic Plans -- Summary of Key Points -- 2: Creating and Sustaining Relationships -- 4: Integrating for Success -- Provider Relationships -- Member Relationships -- Community and Other External Relationships -- Employee Relationships -- Summary of Key Points -- 5: Creating Lasting State Relationships |
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Structuring Lasting RelationshipsDefining Your Main Customer -- Read the Contract -- Reporting -- Transparency and Disclosuresâ#x80;#x8A; -- Breadth and Depth of the Relationship -- Communications -- Written Communications -- Attitudinal and Non-Verbal Communicationsâ#x80;#x8A; -- Measuring Effectiveness -- What to Measure -- Repairing Broken State Relationships -- Summary of Key Points -- 6: Sustaining Success -- Summary of Key Points -- Referencesâ#x80;#x8A; -- Resources |
| Summary |
"Leading Medicaid Managed Care Plans examines leadership actions necessary to successfully operate a Medicaid managed care plan with emphasis on the relationship with the state Medicaid agency the health plan is contracted with. With appropriate operational and governance oversight, and with solid mutually respectful relationships with the state agency, Medicaid health plans are more likely to sustain success and prosperity for the long term. The approach of Leading Medicaid Managed Care Plans builds on key infrastructure elements that need to be in place when contracting with a state agency, and for overall success of the organization. It takes a pragmatic and methodical approach, interspersed with real-life examples of what to do for success and what actions to avoid that frequently lead to failure. This approach is different from most managed care books (Medicaid or otherwise) as those mostly focus on the process of the business (such as details around claims payment, or provider contracting) and ignore the role of the state Medicaid agency and its importance in retaining the contractual relationship. This book differs also on its emphasis on organizational foundational elements and strategic leadership skills necessary to sustain success. The author has years of experience in turning around failing Medicaid managed care plans and observing what they all had in common that contributed to those failures. One common feature was the deterioration of the relationship with the state Medicaid agency they were contracted with, and how close they all came to losing their multi-million dollar businesses. The purpose of this book is to educate and inspire managed care executives and senior leaders who operate Medicaid health plans and to help them understand what elements are needed for successful health plans and a sustainable relationship with the people directing the state Medicaid agency."--Provided by publisher |
| Bibliography |
Includes bibliographical references and index |
| Notes |
Print version record |
| Subject |
Medicaid.
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Managed care plans (Medical care) -- United States
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Medicaid
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Managed care plans (Medical care)
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Medicaid
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United States
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| Form |
Electronic book
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| ISBN |
9781351398428 |
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1351398423 |
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9781351398435 |
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1351398431 |
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9781351398411 |
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1351398415 |
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