Report advises profit cap on insurers that manage Medicaid care in Virginia

Report advises profit cap on Medicaid care management firms in Virginia

A new legislative report recommends that Virginia consider a tighter cap on profits for insurance companies that manage care for most people in the state’s Medicaid program.

The report delivered Monday to the Joint Legislative Audit and Review Commission also suggests that the state Medicaid program increase its oversight of inefficient spending by managed-care companies — estimated at $17 million to $36 million last year compared with other states — and improve its forecasting of costs in setting rates that insurers charge on a monthly per-capita basis to manage care.

The JLARC study said the state should increase oversight of managed care — established more than 20 years ago and steadily expanded to better control Medicaid costs — to limit spending that consumes an increasing share of the state budget but has grown relatively little on a per-capita basis in the past five years after adjusting for inflation.

Instead, the Department of Medical Assistance Services has made service quality a higher priority than controlling spending, the report states. “Focusing on quality can produce long-term savings, but this needs to be balanced with strategies to more directly control spending.”

Read the full story at the Richmond Times-Dispatch: Report recommends that Va. consider cap on profits for insurance companies managing care in Medicaid program – Richmond Times-Dispatch: Virginia Politics