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Healthy Start Initiative: Collaboration With Managed Care Organizations, Volume V

NCJ Number
169853
Author(s)
M S Joffe; K Back
Date Published
1997
Length
125 pages
Annotation
This manual assists Healthy Start projects and their subcontracting service providers in developing proposals and entering into contracts with health maintenance organizations (HMO's) that serve Medicaid clients.
Abstract
The Healthy Start Initiative was first developed as a national demonstration program that uses a community-driven, systems development approach to reduce infant mortality and improve the health and well-being of women, infants, children, and families. This manual instructs its users in the nature and assessment of the needs and responsibilities of HMO's, as well as how to evaluate the capabilities of the Healthy Start project and its subcontractors. In addition, users are instructed in how to identify the specific needs of targeted HMO's and how to evaluate and adapt the organizational structure and services of the Healthy Start project and its service providers to meet those needs. Users are also instructed in the development and marketing of a managed care proposal and how to propose and negotiate a managed care contract. The manual provides suggestions and a range of approaches to guide Healthy Start projects and other community-based projects through the process of developing relationships with HMO's. Finally, the manual includes information to guide community-based organizations in entering into a range of relationships with HMO's. Appended glossary of managed care terms, model contracts between an HMO and a Healthy Start project, a model contract between a Healthy Start project and a subcontracting service provider, a list of State Medicaid agencies with telephone numbers and contacts, and a list of each maternal and child health State agency with telephone number and contacts