evna.care
Google Keyword Rankings for : how is managed care paid for
1
https://www.macpac.gov/subtopic/medicaid-managed-care-payment/
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https://www.macpac.gov/subtopic/medicaid-managed-care-payment/
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2
https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/
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https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-medicaid-managed-care/
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3
https://www.medicaid.gov/medicaid/managed-care/index.html
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https://www.medicaid.gov/medicaid/managed-care/index.html
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4
https://payrhealth.com/resources/blog/how-managed-care-contracts-impact-reimbursement/
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https://payrhealth.com/resources/blog/how-managed-care-contracts-impact-reimbursement/
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5
https://www.gao.gov/products/gao-22-105731
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https://www.gao.gov/products/gao-22-105731
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6
https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation
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https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation
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7
https://www.health.ny.gov/health_care/managed_care/
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https://www.health.ny.gov/health_care/managed_care/
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8
https://www.urban.org/sites/default/files/publication/66136/309064-Medicaid-Managed-Care-Payment-Methods-and-Capitation-Rates.PDF
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https://www.urban.org/sites/default/files/publication/66136/309064-Medicaid-Managed-Care-Payment-Methods-and-Capitation-Rates.PDF
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9
https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/CapitatedModel
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https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/CapitatedModel
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10
https://www.healthmanagement.com/wp-content/uploads/Health-Care-Providers-and-Value-Based-Reimbursement.pdf
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https://www.healthmanagement.com/wp-content/uploads/Health-Care-Providers-and-Value-Based-Reimbursement.pdf
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11
https://www.chcf.org/wp-content/uploads/2017/12/PDF-capitation.pdf
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https://www.chcf.org/wp-content/uploads/2017/12/PDF-capitation.pdf
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12
https://www.rwjbh.org/documents/rwj%20new%20brunswick/mc_answer-guide.pdf
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https://www.rwjbh.org/documents/rwj%20new%20brunswick/mc_answer-guide.pdf
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13
https://www.hhs.texas.gov/providers/medicaid-supplemental-payment-directed-payment-programs
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https://www.hhs.texas.gov/providers/medicaid-supplemental-payment-directed-payment-programs
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14
https://www2.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/ManagedCare.aspx
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https://www2.illinois.gov/hfs/MedicalProviders/MedicaidReimbursement/Pages/ManagedCare.aspx
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15
https://www.cdc.gov/nchs/hus/sources-definitions/managed-care.htm
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https://www.cdc.gov/nchs/hus/sources-definitions/managed-care.htm
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16
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496870/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496870/
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17
https://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html
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https://www.pbs.org/wgbh/pages/frontline/shows/doctor/care/capitation.html
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18
https://revcycleintelligence.com/features/understanding-the-fundamentals-of-accountable-care-organizations
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https://revcycleintelligence.com/features/understanding-the-fundamentals-of-accountable-care-organizations
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19
https://caph.org/wp-content/uploads/2018/09/managed-care-rule-fact-sheet-april-2018.pdf
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https://caph.org/wp-content/uploads/2018/09/managed-care-rule-fact-sheet-april-2018.pdf
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20
https://medicaid.ohio.gov/resources-for-providers/managed-care/payment-standards
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https://medicaid.ohio.gov/resources-for-providers/managed-care/payment-standards
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21
https://www.commonwealthfund.org/blog/2022/how-differences-medicaid-medicare-and-commercial-health-insurance-payment-rates-impact
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https://www.commonwealthfund.org/blog/2022/how-differences-medicaid-medicare-and-commercial-health-insurance-payment-rates-impact
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22
https://www.hfma.org/topics/landing-payment-reimbursement-and-managed-care.html
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https://www.hfma.org/topics/landing-payment-reimbursement-and-managed-care.html
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23
https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000050.asp
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https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000050.asp
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24
https://www.cigna.com/knowledge-center/what-is-managed-care
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https://www.cigna.com/knowledge-center/what-is-managed-care
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25
https://www.stic-cil.org/pdf/Health%20Info/Understanding%20Managed%20Care.pdf
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https://www.stic-cil.org/pdf/Health%20Info/Understanding%20Managed%20Care.pdf
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26
https://healthpayerintelligence.com/news/gao-gaps-remain-in-medicaid-managed-care-direct-payments-oversight
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https://healthpayerintelligence.com/news/gao-gaps-remain-in-medicaid-managed-care-direct-payments-oversight
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27
https://www.faegredrinker.com/en/services/services/health-care/managed-care-and-value-based-arrangements
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https://www.faegredrinker.com/en/services/services/health-care/managed-care-and-value-based-arrangements
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28
https://www.bettercareplaybook.org/payment-managed-care-models
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https://www.bettercareplaybook.org/payment-managed-care-models
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29
https://www.aapacn.org/article/frustrated-by-managed-care-payment-denials-learn-to-spot-key-landmines/
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https://www.aapacn.org/article/frustrated-by-managed-care-payment-denials-learn-to-spot-key-landmines/
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30
https://ccf.georgetown.edu/2022/04/08/medicaid-managed-care-compliance-tools-another-pay-for/
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https://ccf.georgetown.edu/2022/04/08/medicaid-managed-care-compliance-tools-another-pay-for/
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31
https://www.medicaidplanningassistance.org/medicaid-managed-long-term-care/
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https://www.medicaidplanningassistance.org/medicaid-managed-long-term-care/
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32
https://www.osc.state.ny.us/state-agencies/audits/2021/02/11/improper-fee-service-payments-services-covered-managed-care-follow
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https://www.osc.state.ny.us/state-agencies/audits/2021/02/11/improper-fee-service-payments-services-covered-managed-care-follow
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33
https://www.chcs.org/leveraging-prospective-payments-to-address-provider-financial-shortfalls-the-role-of-managed-care-organizations/
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https://www.chcs.org/leveraging-prospective-payments-to-address-provider-financial-shortfalls-the-role-of-managed-care-organizations/
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34
https://www.sciencedirect.com/science/article/pii/B978012811325700018X
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https://www.sciencedirect.com/science/article/pii/B978012811325700018X
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35
https://www.modernhealthcare.com/medicaid/macpac-wants-more-managed-care-directed-payment-transparency
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https://www.modernhealthcare.com/medicaid/macpac-wants-more-managed-care-directed-payment-transparency
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36
https://www.hsd.state.nm.us/wp-content/uploads/files/Providers/New%20Mexico%20Administrative%20Code%20Program%20Rules%20and%20Billing/NMAC%20Program%20Rules/Chapter%20308/8_308_20.pdf
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https://www.hsd.state.nm.us/wp-content/uploads/files/Providers/New%20Mexico%20Administrative%20Code%20Program%20Rules%20and%20Billing/NMAC%20Program%20Rules/Chapter%20308/8_308_20.pdf
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37
https://www.diffen.com/difference/Capitation_vs_Fee_For_Service
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https://www.diffen.com/difference/Capitation_vs_Fee_For_Service
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38
https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/managed-care-and-long-term-care
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https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/managed-care-and-long-term-care
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39
https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder2/Folder71/Folder1/Folder171/Q-and-A-on-Increased-Medicaid-Payments-for-PCPs-managed-care.pdf?rev=6d3a5525aecb464fb402b6843523775d
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https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder2/Folder71/Folder1/Folder171/Q-and-A-on-Increased-Medicaid-Payments-for-PCPs-managed-care.pdf?rev=6d3a5525aecb464fb402b6843523775d
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40
https://www.mathematica.org/projects/supporting-cms-oversight-of-medicaid-managed-care-payment-strategies
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https://www.mathematica.org/projects/supporting-cms-oversight-of-medicaid-managed-care-payment-strategies
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41
https://scholar.harvard.edu/files/cutler/files/how_does_managed_care_do_it.pdf
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https://scholar.harvard.edu/files/cutler/files/how_does_managed_care_do_it.pdf
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42
https://dch.georgia.gov/programs/state-directed-payment-programs
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https://dch.georgia.gov/programs/state-directed-payment-programs
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43
https://www.flsenate.gov/Session/Bill/2022/7047/Analyses/h7047a.HCA.PDF
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https://www.flsenate.gov/Session/Bill/2022/7047/Analyses/h7047a.HCA.PDF
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44
https://news.bloomberglaw.com/health-law-and-business/insight-the-healthcare-industrys-shift-from-fee-for-service-to-value-based-reimbursement
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https://news.bloomberglaw.com/health-law-and-business/insight-the-healthcare-industrys-shift-from-fee-for-service-to-value-based-reimbursement
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45
https://guidehouse.com/insights/healthcare/2022/blogs/managed-care-implement-vbp-models
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https://guidehouse.com/insights/healthcare/2022/blogs/managed-care-implement-vbp-models
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46
https://www.healthaffairs.org/do/10.1377/forefront.20180430.387981/full/
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https://www.healthaffairs.org/do/10.1377/forefront.20180430.387981/full/
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47
https://www.ajmc.com/view/managed-care-for-long-stay-nursing-home-residents-an-evaluation-of-institutional-special-needs-plans
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https://www.ajmc.com/view/managed-care-for-long-stay-nursing-home-residents-an-evaluation-of-institutional-special-needs-plans
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48
https://www.shvs.org/wp-content/uploads/2017/04/Value-Based-Payment-Models_4.10.pdf
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https://www.shvs.org/wp-content/uploads/2017/04/Value-Based-Payment-Models_4.10.pdf
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49
https://www.govinfo.gov/content/pkg/FR-2016-05-06/pdf/2016-09581.pdf
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https://www.govinfo.gov/content/pkg/FR-2016-05-06/pdf/2016-09581.pdf
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50
https://www.nashp.org/wp-content/uploads/2018/04/How-States-Structure-Medicaid-Managed-Care.pdf
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https://www.nashp.org/wp-content/uploads/2018/04/How-States-Structure-Medicaid-Managed-Care.pdf
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51
https://www.dmhc.ca.gov/Portals/0/AbouttheDMHC/FSSB/meetings/20150617/MediCal.pdf
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https://www.dmhc.ca.gov/Portals/0/AbouttheDMHC/FSSB/meetings/20150617/MediCal.pdf
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52
https://www.youtube.com/watch?v=JYLhrwjc2Ok
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https://www.youtube.com/watch?v=JYLhrwjc2Ok
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53
https://dss.mo.gov/mhd/mc/pages/overview.htm
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https://dss.mo.gov/mhd/mc/pages/overview.htm
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54
https://files.nc.gov/ncdhhs/VBP_Strategy_Final_20200108.pdf
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https://files.nc.gov/ncdhhs/VBP_Strategy_Final_20200108.pdf
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55
https://www.federalregister.gov/documents/2017/01/18/2017-00916/medicaid-program-the-use-of-new-or-increased-pass-through-payments-in-medicaid-managed-care-delivery
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https://www.federalregister.gov/documents/2017/01/18/2017-00916/medicaid-program-the-use-of-new-or-increased-pass-through-payments-in-medicaid-managed-care-delivery
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56
https://www.dhs.state.mn.us/id_008923/
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https://www.dhs.state.mn.us/id_008923/
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57
https://www.catalyze.org/wp-content/uploads/woocommerce_uploads/2019/12/Medicaid-MCOs-as-Agents-of-Payment-Reform-1.pdf
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https://www.catalyze.org/wp-content/uploads/woocommerce_uploads/2019/12/Medicaid-MCOs-as-Agents-of-Payment-Reform-1.pdf
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58
https://www.legis.iowa.gov/DOCS/ACO/IAC/LINC/Chapter.441.73.pdf
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https://www.legis.iowa.gov/DOCS/ACO/IAC/LINC/Chapter.441.73.pdf
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59
https://www.ahcancal.org/Reimbursement/Medicare/Documents/Managed%20Care%20Playbook%20-%20FINAL.pdf
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https://www.ahcancal.org/Reimbursement/Medicare/Documents/Managed%20Care%20Playbook%20-%20FINAL.pdf
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60
https://us.milliman.com/insight/pass-through-payment-guidance-in-final-medicaid-managed-care-regulations-transitioning-to
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https://us.milliman.com/insight/pass-through-payment-guidance-in-final-medicaid-managed-care-regulations-transitioning-to
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61
https://www.manatt.com/Manatt/media/Documents/Articles/Medicaid-Managed-Care-Rate-Setting-and-Payment-Innovation-Study.pdf
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https://www.manatt.com/Manatt/media/Documents/Articles/Medicaid-Managed-Care-Rate-Setting-and-Payment-Innovation-Study.pdf
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62
https://www.dmas.virginia.gov/media/2104/va-medicaid-managed-care-10-2-2019_final-draft.pdf
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https://www.dmas.virginia.gov/media/2104/va-medicaid-managed-care-10-2-2019_final-draft.pdf
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63
https://www.law.cornell.edu/cfr/text/42/438.6
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https://www.law.cornell.edu/cfr/text/42/438.6
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64
https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&ti=1&ch=353&rl=4
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https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&ti=1&ch=353&rl=4
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65
https://www.ncmedicaljournal.com/content/80/5/297
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https://www.ncmedicaljournal.com/content/80/5/297
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66
https://resdac.org/articles/medicaid-analytic-extract-data-identification-medicaid-managed-care-beneficiaries
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https://resdac.org/articles/medicaid-analytic-extract-data-identification-medicaid-managed-care-beneficiaries
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67
https://ojin.nursingworld.org/table-of-contents/volume-2-1997/number-1-january-1997/glossary-for-managed-care/
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https://ojin.nursingworld.org/table-of-contents/volume-2-1997/number-1-january-1997/glossary-for-managed-care/
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68
https://sphweb.bumc.bu.edu/otlt/mph-modules/hpm/americanhealthcare_paying/AmericanHealthCare_Paying7.html
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https://sphweb.bumc.bu.edu/otlt/mph-modules/hpm/americanhealthcare_paying/AmericanHealthCare_Paying7.html
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69
https://www.oversight.gov/sites/default/files/oig-reports/11700004.pdf
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https://www.oversight.gov/sites/default/files/oig-reports/11700004.pdf
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70
https://www.bipc.com/reimbursement-and-managed-care
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https://www.bipc.com/reimbursement-and-managed-care
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71
https://www.milbank.org/publications/strategies-to-encourage-home-and-community-based-care-through-value-based-contracting-in-managed-care/
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https://www.milbank.org/publications/strategies-to-encourage-home-and-community-based-care-through-value-based-contracting-in-managed-care/
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72
https://ldh.la.gov/assets/medicaid/RFP_Documents/RFP3/AppendixB.pdf
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https://ldh.la.gov/assets/medicaid/RFP_Documents/RFP3/AppendixB.pdf
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73
https://www.britannica.com/topic/managed-care
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https://www.britannica.com/topic/managed-care
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74
https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid
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https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid
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75
https://www.cmhealthlaw.com/2021/02/2020-medicaid-managed-care-rule-summary/
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https://www.cmhealthlaw.com/2021/02/2020-medicaid-managed-care-rule-summary/
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76
https://www.forbes.com/sites/howardgleckman/2016/10/21/long-term-care-is-increasingly-becoming-managed-care-at-home/
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https://www.forbes.com/sites/howardgleckman/2016/10/21/long-term-care-is-increasingly-becoming-managed-care-at-home/
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77
https://www.health-law.com/newsroom-advisories-130.html
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https://www.health-law.com/newsroom-advisories-130.html
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78
https://study.com/learn/lesson/managed-care-history-systems-types.html
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https://study.com/learn/lesson/managed-care-history-systems-types.html
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79
https://ahca.myflorida.com/medicaid/statewide_mc/pdf/plan_comm/PT_16-27_Attachment_Kick-Payments-Tip-Sheet.pdf
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https://ahca.myflorida.com/medicaid/statewide_mc/pdf/plan_comm/PT_16-27_Attachment_Kick-Payments-Tip-Sheet.pdf
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80
https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=030500050K5-30.1
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https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=030500050K5-30.1
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81
https://www.leadingageny.org/home/assets/File/Managed%20Care_How%20Have%20We%20Fared%20_%20Bonadio.pdf
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https://www.leadingageny.org/home/assets/File/Managed%20Care_How%20Have%20We%20Fared%20_%20Bonadio.pdf
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82
https://www.priorauthtraining.org/what-is-managed-care/
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https://www.priorauthtraining.org/what-is-managed-care/
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83
https://www.northcarolinahealthnews.org/2021/10/19/three-months-into-medicaid-transformation-providers-say-the-new-administrative-burdens-are-crushing/
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https://www.northcarolinahealthnews.org/2021/10/19/three-months-into-medicaid-transformation-providers-say-the-new-administrative-burdens-are-crushing/
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84
https://medlineplus.gov/managedcare.html
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https://medlineplus.gov/managedcare.html
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85
https://courses.lumenlearning.com/atd-clinton-hsm111/chapter/managed-care-organization/
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https://courses.lumenlearning.com/atd-clinton-hsm111/chapter/managed-care-organization/
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86
https://www.certifi.com/blog/what-is-medicaid-capitated-payment-reconciliation/
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https://www.certifi.com/blog/what-is-medicaid-capitated-payment-reconciliation/
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87
https://casemanagementstudyguide.com/ccm-knowledge-domains/healthcare-reimbursement/managed-care-concepts-and-rules-for-reimbursement/
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https://casemanagementstudyguide.com/ccm-knowledge-domains/healthcare-reimbursement/managed-care-concepts-and-rules-for-reimbursement/
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88
https://skillednursingnews.com/2020/08/all-or-nothing-for-snfs-managed-care-is-not-something-you-can-dabble-in/
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https://skillednursingnews.com/2020/08/all-or-nothing-for-snfs-managed-care-is-not-something-you-can-dabble-in/
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89
https://center-forward.org/what-is-medicaid-managed-care/
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90
https://www.coursera.org/lecture/healthcare-payment-models/managed-care-lBdFi
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https://www.coursera.org/lecture/healthcare-payment-models/managed-care-lBdFi
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91
https://www.mass.gov/doc/managed-care-entity-bulletin-50-coverage-and-payment-for-coronavirus-disease-2019-covid-19-0/download
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https://www.mass.gov/doc/managed-care-entity-bulletin-50-coverage-and-payment-for-coronavirus-disease-2019-covid-19-0/download
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92
https://academyhealth.org/sites/default/files/implementing_sdoh_medicaid_managed_care_may2018.pdf
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https://academyhealth.org/sites/default/files/implementing_sdoh_medicaid_managed_care_may2018.pdf
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93
https://www.decorm.com/managed-care/
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94
https://www.bluecrossmafoundation.org/sites/g/files/csphws2101/files/2020-10/MMPI%20Primer%20on%20MCO%20Capitation%20Rates.pdf
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95
https://dhss.delaware.gov/dhss/dmma/faqs.html
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96
https://fas.org/sgp/crs/misc/R45432.pdf
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