Nebraska Medicaid Program

Managed Care

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Medicaid Managed Care is the way some clients receive their Medicaid benefits.  Managed Care is a service delivery system where Nebraska Medicaid contracts with a Managed Care Organization (MCO) to operate a health plan that authorizes, arranges, provides and pays for the delivery of services to enrolled clients.  Nebraska utilizes Managed Care to provide physical and behavioral (mental health and substance use disorder) health services and is working to implement a program to provide Managed Long-Term Services and Supports.
 

The care of enrolled clients in the Physical Health plans is managed by MCOs through their networks of Primary Care Providers (PCPs), specialists, hospitals, and other providers of care who contract directly with the MCO.  Managed care offers an opportunity to assure access to a PCP, coordination of medical care, emphasizes preventive care, and encourages the appropriate utilization of services in the most cost-effective settings.

The care of enrolled clients in the Behavioral Health plan is offered through a network of providers who contract directly with a Managed Care Plan. The goal of this new delivery system is to provide services consistent with best practices that will decrease reliance on emergency and inpatient levels of care, increase evidence-based treatment, increase outcome-driven community-based programming and support, increase coordination between service providers, promote a Recovery Oriented System of Care, and increase access to high quality services to meet the needs of our diverse clients.

Managed Long-Term Services and Supports - Learn more about this program which is in development. 


 

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