Category: MCO
Why Compliance Is Critical for Medicaid MCOs
Direct Care Innovations provides software solutions that empower Medicaid Agencies to succeed. In an industry where compliance and training are critical, Managed Care Organizations play a vital role in delivering healthcare services to millions of low-income and vulnerable individuals through state Medicaid programs. With such a significant responsibility, strict adherence to federal and state regulations […]
Understanding California’s Medi-Cal Budget
Medi-Cal, California’s Medicaid program, provides health coverage to millions of low-income residents, including children, seniors, and individuals living with disabilities. As a critical part of the state’s healthcare system, Medi-Cal’s budget is a major financial consideration for policymakers, especially in the face of rising costs and economic uncertainties. Direct Care Innovations, the leading provider of […]
Key Insights to Understanding Medicaid Managed Care
At Direct Care Innovations, we’re committed to keeping you informed on the latest developments in Medicaid news. Medicaid plays a crucial role in providing healthcare coverage to millions of low-income Americans, and managed care has become the primary way states deliver services to enrollees. As of 2023, over 70% of Medicaid beneficiaries receive their care […]
Community Reinvestment Mandates for MCOs
State Medicaid agencies are increasingly mandating community reinvestment requirements in contracts with Medicaid managed care organizations (MCOs). These requirements necessitate that MCOs reinvest a portion of their profits back into the communities they serve to improve health outcomes. At least ten states have adopted or are implementing such requirements. Direct Care Innovations provides solutions that […]
3 Factors Surrounding Medicaid & Managed Care Organizations
In partnership with states nationwide, risk-based Managed Care Organizations (MCOs) coordinate essential healthcare services for Medicaid enrollees living with intellectual and developmental disabilities (IDD). Over the last decade, COVID-19 and other global and national events have greatly influenced the utilization of risk-based MCOs. Direct Care Innovations has adapted to these changes and continues to support […]
3 Current Updates Regarding Medicaid & Managed Care
Over the last few years, several updates have been made to Medicaid and managed care. With the Medicaid unwinding process taking place, the Centers for Medicare and Medicaid Services (CMS) and Managed Care Organizations (MCOs) are working together to help Medicaid-eligible members retain their current coverage. Direct Care Innovations is watching these changes closely to […]