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Integrated Delivery Systems In Managed Care
Challenges to Public Purchasers
Contracting With Integrated Delivery Systems
Presenter: James A. Chase, Director of Purchasing and Service Delivery, Minnesota Department of Human Services, St.
Paul, MN.
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This session focused on the purchase of services from integrated delivery
systems (IDSs) by public purchasers, especially
Medicaid, highlighting who to contract with and what to contract for.
Mr. Chase explained that the challenges are greater
in long-term care and disability programs rather than in acute care. He said that in Minnesota, establishing an adequate
primary care network is going well but that ancillary care (e.g., home health) is more of a challenge.
Other challenges
facing public purchasers include:
- Determining appropriate provider payments and risk adjustment.
- Educating recipients.
- Plan features.
- Portability.
- Lack of competition in rural areas.
- Capacity of the IDS to manage and monitor all care provided.
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