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Date: Friday, Feb. 13, 1998 FOR IMMEDIATE RELEASE Contact: HCFA Press Office(202) 690-6145
Under the Medicaid 1115 waiver for the Managed Charity Care Demonstration (MCCD), hospitals will be required to develop "hospital-centered managed care networks." These networks will deliver coordinated care to certain low-income indivi duals whose conditions can benefit from a coordinated approach to treatment. The state hopes to serve more uninsured low-income residents through the more efficient use of disproportionate share hospital funds and by using less costly and intensive care settings.
"This project demonstrates our commitment to working with states on innovative programs that ensure our neediest citizens get top quality care in the most appropriate setting," said DeParle.
Participation in the new program is voluntary. Uninsured individuals with family incomes up to 200 percent of the federal poverty level are entitled to fully-subsidized inpatient and outpatient care under the state's current program, while those whose incomes fall between 200 percent and 300 percent of the poverty level are eligible for partial subsidies. The federal poverty level is $16,050 for a family of four. Eligibility for the new MCCD program will remain the same.
Rather than offering a specific benefit package, hospitals will offer services that are tailored to the specific needs of their own patients. However, substance abuse and mental health services must be offered by the MCCD as well as any other con ditions that would benefit from care coordination such as diabetes, hypertension and prenatal care also may be included.
Hospitals are also required to establish a quality assessment program that will monitor availability, accessibility, continuity and quality of care on an on-going basis.
"By fostering the creation of innovative coordinated care delivery systems, New Jersey will increase access to quality health care for its uninsured residents," said DeParle.