Impacts of the New Federal Medicaid Managed Care Rule

CMS SPECIAL COVERAGE

Published: October 7, 2024

Opportunities to Improve Access and Quality of Care for Medicaid Beneficiaries

The managed care delivery system has grown to be the primary model for delivering Medicaid services to approximately 75% of the Medicaid population, and it has been almost a decade since the last set of comprehensive managed care rules were released.

On April 22, 2024, CMS released for public inspection a final rule, Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality. Through these final rules, CMS seeks to promote consistency and transparency, focusing on improving access and driving quality for Medicaid beneficiaries served by managed care plans.

Our latest issue brief, created in collaboration with Population Health Alliance, aims to summarize key provisions within the 2024 final managed care rule and assess potential impacts and opportunities for states, MCOs, providers, and solution partners to meet the intended goal of improving access to and the quality of care for Medicaid enrollees.

Click here to download the issue brief, today.

Plus, explore more insights from Sellers Dorsey on the final managed care rule, including our recorded webinar.
Click here for more insights!

Brian Dees

As a former Senior Advisor to the Deputy Associate Commissioner for Medicaid and CHIP Policy and Program for Texas HHSC, Brian led high-profile Managed Long-Term Services and Supports (MLTSS) program implementations, interacted with a variety of stakeholders, developed Medicaid policy, and provided legislative analysis and ongoing management of provider and client-related issues to the Medicaid program in Texas. Prior to becoming a Senior Advisor, Brian worked as a Senior Policy Analyst conducting policy analysis related to acute care and LTSS in the Medicaid and CHIP programs.

Current Responsibility

Brian leverages his expertise in Medicaid managed care and health policy to provide technical, strategic, and business planning support to an array of Sellers Dorsey’s clients including state health plans, managed care organizations (MCOs), Medicaid support vendors, providers, and private equity firms. Brian also serves as a key member of the Sellers Dorsey Research and Policy team, which conducts timely research and tracking of federal legislative, regulatory, and judicial actions impacting Medicaid.