For example, the Department has developed a booklet for inmates that describes what medical services will and will not be covered. Furthermore, in March 1996 the Department began negotiations to contract with a private firm for external utilization management and other administrative services, including processing external provider claims and preparing management reports. During the period of review by the contractor, the Department of Corrections had not yet made the determination to continue with Phase II of the test implementation of a cooperative managed care program. Since that time a contract was developed and includes objectives, performance requirements, criteria, and data needed, and provides for the program's evaluation. The contract is substantial and meets all recommendations by the auditor.
Contracting is one of several approaches for implementing managed care in a correctional setting.
According to recent research, contracting for management and operation of inmate medical services has raised the level of correctional health care. Our analysis of responses from 13 of the 17 states that have comprehensive contracts for inmate health care confirms research information on contracting benefits. Benefits of total managed care include cost savings, balanced budgets, increased effectiveness, and greater flexibility in staffing. We believe the Department of Corrections should explore all avenues for managed health care. It should develop a strategic plan for moving to a full-managed care system.