Contracting with Health Plans: Key Considerations for Providers

Many states are implementing managed long-term services and supports (LTSS) to better coordinate care for Medicaid recipients. This may change the way your organization provides Medicaid services by requiring you to contract or enter into an agreement with one or more health plans rather than directly with the state. Working with health plans might be a new experience for you or your organization. Similarly, health plans may have limited or no experience working with LTSS providers. This brief outlines general considerations for organizations such as yours when contracting or entering into agreements with health plans.

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