The Healthy Start Initiative PDF Download

The Healthy Start Initiative is a national 5-year demonstration program that uses a broad range of community-driven, system development approaches to reduce infant mortality and improve the health and well-being of women, infants, children, and families. This volume, fifth in the series, deals with the topic of collaborating with managed care organizations. The book is designed to assist Healthy Start projects and their subcontracting service providers in developing proposals and entering into contracts with health maintenance organizations (HMOs) that serve Medicaid clients. It is designed to help these organizations: (1) understand and evaluate the needs and responsibilities of HMOs; (2) evaluate the capabilities of the Healthy Start project and its subcontractors; (3) identify the specific needs of targeted HMOs, and evaluate and adapt the organizational structure and services of the Healthy Start project and its service providers to meet those needs; (4) develop and market a managed care proposal; and (5) propose and negotiate a managed care contract. This report has 11 chapters: (1) "Introduction"; (2) "HMOs: The Basics"; (3) "Your State's Medical Managed Care Program and Opportunities for Healthy Start"; (4) "Factors Influencing an HMO's Willingness to Contract with a Healthy Start Project"; (5) "Becoming an Attractive Partner to HMOs"; (6) "Preparing To Act as a Contractor to HMOs"; (7) "Strategic Planning: How To Decide What Services To Offer to HMOs"; (8) "Developing and Marketing a Managed Care Proposal"; (9) "Proposing and Negotiating a Contract"; (10)"Ongoing Issues"; and (11) "Conclusion." Five appendices contain a glossary of terms, annotated HMO-Healthy Start Project contracts, a Healthy Start Project subcontractor agreement, a list of state Medicaid directors, and state maternal and child health contacts. (LPP)