The State creates it's own network and contracts with those providers. There are utilization controls on inpatient hospital stays and certain other services. Patients maintain a broad choice of physicians and facilities. The primary care physician serves as the medical home. For maintaining the medical home, the primary care physician receives a monthly fee in addition to the Medicaid fee schedule.
Patients are able to choose where they receive specialty services.
This is the most restrictive of the managed care plans. Primary and specialty care providers must apply to the plans network in order to participate. Physicians are reimbursed through capitation, fee for service or both. Medical groups or provider networks are capitated for physician, lab and x-ray services. Individual physicians may or may not be capitated.