Center for Health Services Financing and Managed Care

The Center for Health Services Financing and Managed Care helps all HRSA grantees better understand and participate in the various health service financing and reimbursement systems to ensure the maximum use of Federal grant funds for services to the uninsured. The Center offers a coordinated program of technical assistance, training, policy leadership and evaluations.

The Center's operations are focused on four major activities:

Technical Assistance, Training and Information

The Center provides HRSA grantees with a wide range of technical assistance, training and information around financing and managed care systems to improve service delivery.

HRSA Managed Care Technical Assistance Center (MCTAC) - HRSA's Managed Care Technical Assistance Center is designed to aid HRSA grantees in navigating health services financing and managed care arrangements for underserved populations. Sponsored workshops and training sessions are offered by the Center to meet the needs of grantees on such topics as eligibility determination, claims management, proper coding, capitation setting and management, contract negotiation, medical and utilization management, information systems management, risk arrangements and curriculum development.

Training on Public and Private Third Party Reimbursement Systems - The Center provides assistance to grantees in establishing and maintaining effective third party reimbursement billing and claims systems to increase grantee reimbursements from other public and private health financing systems to maximize Federal grant funds.

Technical Assistance (Onsite, Online, or by Telephone) - The Center offers HRSA grantees a range of flexible and cost sensitive resources regarding health services and managed care arrangements.

For technical assistance on managed care, contact the HRSA Managed Care Technical Assistance Center at:

1555 Wilson Boulevard, Suite 520
Arlington, Va. 22209
Telephone: 877-832-8635 (toll free)
Fax: 703-528-7480
E-Mail: hrsa_mctac@jsi.como
Web Site: www.jsi.com/hrsamctac (operated under contract by John Snow Inc.)

For technical assistance on third party reimbursements, contact the Center for Health Services Financing and Managed Care at:

Room 10-29, Parklawn Building
5600 Fishers Lane
Rockville, Md. 20857
Telephone: 301-443-1550
Fax: 301-443-5641
E-mail: financeMC@hrsa.gov

Policy Leadership

The Center provides policy leadership on health services financing and managed care for at-risk, underserved populations, using a variety of mechanisms.

Purchasing Specification Development for Grantees in Managed Care Contracting - The Center participates in a joint effort with CDC, SAMSHA, other Federal Agencies, and George Washington University to develop sample managed care purchasing specifications for States and other purchasers. These optional guides assist States and purchasers in procuring basic health services for: (1) both Medicaid and SCHIP enrolled children, including children with special health care needs and; (2) services affecting a variety of public health concerns, including HIV/AIDS, immunizations, lead poisoning, dental care, diabetes, and adolescent and school health. These and other specifications are available on the internet at www.gwu.edu/~chsrp

Convenes State/Local HRSA Grantees and Medicaid Officials in regional meetings to discuss policy issues of mutual concern that are affected by the intersection of HRSA grant programs with the Medicaid and SCHIP programs.

Review of Medicaid Policies and Their Interaction With HRSA Programs - Working with HRSA's Bureaus, the Center coordinates policy analysis, including the review of proposed Medicaid waivers to assure appropriate relationships with HRSA grantees and programs.

Evaluation

Assuring Access - The Center is engaged in a continuing effort to understand how the country’s changing demographics impact the abilities of public and private health systems to assure access to health services to all Americans. As part of this effort, the Center recently published model technical assistance cultural competency purchasing specifications. In addition, the Center is conducting an analysis of patient access to managed care services to help HRSA grantees better understand access and participation issues with the various forms of managed care delivery systems.

Institute of Medicine (IOM) Study on Managed Care Safety-Net Providers and Underserved Populations -This landmark study focused on how managed care in the Medicaid program and related market forces impact the integrity and viability of the health care safety net system and its providers. The Center is following up the study to determine if change can be monitored in safety net systems around the country.

Conducts Evaluation Studies Examining Impact of Managed Care on specific populations or their providers to determine the effect on HRSA programs, policies and priorities.

Collaboration with Other Organizations

The Center works with a broad range of managed care organizations, health policy researchers, managed care executives, academic institutions and other Federal agencies to carry out its mission. These partnerships support HRSA grantees as they work to maintain effective services to the underserved.

For more information about the HRSA Center for Health Services Financing and Managed Care you may also access the Center web site at www.hrsa.gov/financeMC

For more information, contact: Office of Communications, HRSA
5600 Fishers Lane, Room 14-45
Rockville, MD 20857
Telephone: 301.443.3376
Fax: 301.443.1989
Web Site: http://www.hrsa.gov

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