Utilizing Medicaid plans within the SCHIP program has both
advantages and disadvantages.
Advantages Include:
- More bargaining power with providers due to large number of beneficiaries.
- Use of one benefit package and one set of providers or plans.
- Removal of the need for tracking cost-sharing.
- Use of currently existing networks, data systems, and contract mechanisms.
- Use of non-licensed, Medicaid-defined HMOs.
- Historical providers already familiar with needs of Medicaid population.
Disadvantages Include:
- SCHIP may place additional demand on an already strained system.
- The Medicaid delivery system is still in transition to managed care.
- Medicaid managed care system problems (low rates, service incentives)
have not been resolved.
- Traditional problems under the Medicaid fee-for-service (FFS) system
are still not solved.
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