You are the assistant director for the Medicaid program in the state of Nebraska. The director has decided that it is time to review why the managed care and public policy objectives of implementing the program are not producing the results originally contemplated. Nebraska’s Medicaid staff is limited. Its administrative functions are generally dispersed across the state, rather than centralized. Its database related to care patterns is practically nonexistent. State law prohibits the program from extensive health care marketing. In order to simplify enrollment processes, Nebraska only considers one month’s income as a part of its eligibility process. In addition, Nebraska requires a $30 co-pay for all services from recipients who have income above the poverty guidelines. Nebraska has very few providers per capita.
The director asks you to draft a memo for discussion at the next Medicaid committee meeting that identifies seven (7) problem areas in the Nebraska Medicaid Managed Care Program and explains how each problem could arise. In addition, the Director would like you to write a brief conclusion to the memo explaining how the Program could improve.