Benefits of Delegating Care Management for Managed Medicaid

In the complex landscape of healthcare, managing care for Medicaid beneficiaries is a multifaceted challenge. With the growing demands and intricacies involved in Managed Medicaid, individuals and health organizations in North Carolina alike are finding value in delegating care management responsibilities.

What is Care Management?

Care management is a comprehensive approach to healthcare that focuses on improving patient outcomes and reducing healthcare costs. It involves coordinating care across multiple providers, settings, and disciplines to ensure patients receive the right care at the right time in the right place. By delegating these tasks to qualified professionals, doctors can focus on providing high-quality care to their patients.

Why Delegate Care Management?

  1. Expertise & Specialization: Medicaid care management involves navigating a myriad of rules, regulations, and guidelines. Delegating this responsibility to professionals with expertise in Medicaid can ensure the care provided aligns with the program’s requirements. Healthcare organizations that specialize in Medicaid care management have a deep understanding of the intricate processes involved, ensuring compliance and efficient coordination of services.
  2. Focus on Core Competencies: Healthcare provider’s primary focus should be on delivering quality care, not on administrative tasks. Delegation allows providers to get back to practicing medicine, outsourcing the administrative tasks associated with Managed Medicaid. This leads to increased job satisfaction and reduced burnout among healthcare professionals.
  3. Cost-Effective: Managing care in-house can be resource intensive. Organizations that specialize in care management leverage economies of scale, technology, and streamlined processes to provide more efficient services. This cost-effectiveness results in better utilization of resources and improved financial sustainability.
  4. Enhanced Patient Experience & Health Outcomes: Professional care managers offer personalized support, ensuring Medicaid beneficiaries receive the right care at the right time in the right place. This patient-centric approach fosters better communication, engagement, and coordination, leading to improved patient satisfaction and health outcomes.
  5. Timely Interventions: Practices often lack the resources needed to identify and address health interventions. Professional care managers serve as an extension of a practice, actively coordinating and overseeing patient care. With access to real-time data, these care managers have the ability spot potential issues early and intervene promptly, leading to decreased utilization and better patient outcomes. Delegated care managers also connect with patients after inpatient stay to ensure a seamless transition of care.
  6. Access to Advanced Technology: Outsourcing care management often involves the utilization of advanced technologies for data management, analytics, and communication. This technology enables more streamlined and efficient processes, reducing administrative burdens and improving overall care coordination. Complex risk stratification models assist care managers in identifying rising risk patients before they become more complex, higher cost patients.

Delegating care management for Managed Medicaid brings a host of benefits, from expertise and specialization to cost-efficient solutions and enhanced patient experiences. By embracing this approach, healthcare providers and practices can better meet the needs of their patients and achieve better health outcomes.

About the Author

Denise Tedder

Denise Tedder

Medicaid Hub Manager at CHESS