“We are undertaking this project at a key moment for family planning policy in order to bring greater focus to the key role Medicaid programs generally – and managed care in particular – can play in ensuring high quality family planning services as an integral part of an overall health improvement strategy,” said Sara Rosenbaum, JD.
Milken Institute School of Public Health Receives Grant to Strengthen Family Planning through Medicaid Managed Care
WASHINGTON, DC (Sept. 16, 2020) – Researchers at the George Washington University Milken Institute School of Public Health (Milken Institute SPH) have received a grant to develop strategies for using Medicaid managed care to strengthen access to family planning services.
Family planning represents one of Medicaid’s most important preventive benefits and is critical to the health of women, children, and families. Today, with more than 70 percent of Medicaid beneficiaries enrolled in Medicaid managed care plans, and at a pivotal time for national family planning policy, a key question is how managed care might be used to strengthen family planning without compromising Medicaid’s longstanding family planning direct access protections. These protections ensure that regardless of managed care enrollment, beneficiaries can obtain family planning from their Medicaid provider of choice.
The 20-month project, supported by a $650,000 grant awarded by Arnold Ventures, aims to define issues and opportunities for this channel and identify practical, actionable strategies that state Medicaid programs can use to strengthen the managed care and family planning relationship while preserving Medicaid’s unique family planning freedom of choice safeguards. The project is led by Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH.
“We are undertaking this project at a key moment for family planning policy in order to bring greater focus to the key role Medicaid programs generally – and managed care in particular – can play in ensuring high quality family planning services as an integral part of an overall health improvement strategy,” Rosenbaum said.
Health Management Associates, an independent national research and consulting firm in the healthcare industry, serves as a partner in the project. Peter Shin, PhD, MPH, an associate professor of health policy and management at Milken Institute SPH, serves as a co-investigator.
The project has two phases, Rosenbaum explains. In phase one, the research team will conduct an in-depth review of the contract documents that govern Medicaid managed care in all states that use comprehensive plans as part of their health care delivery strategy. During this phase, the project will seek to understand key choices states make regarding family planning and managed care integration and uncover both promising strategies and potential barriers to fuller integration and seamless delivery of high-quality care. Researchers will also conduct extended interviews with state Medicaid agencies. During the second phase, the research team will hold in-depth discussions with managed care plans and family planning providers (both in-network and out-of-network) to learn more about what works and how relationships might be strengthened. The study will conclude with recommendations aimed at helping states, plans, and providers build and strengthen integrated performance. The project will be guided by an advisory committee of states, plans, providers, consumer representatives, and experts.
“This is the first nationwide study to focus on how to develop stronger ties between managed care and family planning,” Shin said. “It is our hope that we can uncover ways in which states can use their considerable Medicaid purchasing leverage to promote a full continuum of care that includes high quality family planning services.”