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Managed Care 101: Understanding the Basics and ...

TSF Webinar January 8, 2013. Managed care 101: Understanding the Basics and Opportunities for Partnership Bruce A. Chernof, President & CEO. Presentation Overview: Managed care 101. Background Goals and Components of Managed care How it Works California's Medi Cal Managed care Infrastructure Integrating LTSS. New Opportunities Building Partnerships Background & History Early 20th century: Prepaid health plans LA DWP, Kaiser 1960's: Calls for health maintenance organizations 1973 HMO Act: Created organized health systems 1974 ERISA: Protect employer sponsored health coverage from malpractice suits Late 1980's & 1990's: Dramatic HMO growth Late 1990's & 2000's: Public backlash against restrictions 2013: Nearly all working individuals with coverage are insured through some Managed care form Goals of Managed care Control costs Health care costs growing faster than GDP.

Medi‐Cal Managed Care Models • Two Plan Model:State contracts with 2 plans: a local initiative (locally developed and operated), and a commercial plan. ... Managed Care: Integrating Long‐Term Services and Supports ...

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www.tn.gov

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