Third, PCCM programs didn't systematically coordinate or measure quality, outcomes and access. States weren't in it, after all, just to count pennies. Evidence of quality and access mattered. So now, after learning at the feet of MCOs, states are bringing the desirable MCO principles into their new, improved, second-generation PCCM programs. PCCM programs, in short, closely resemble risk-based managed care, with the states, rather than MCOs, controlling the overall enterprise.
States are nimble.
For example, Ohio, shaken by MCO withdrawal over rate-setting disputes, is revitalizing a PCCM program that now has very meaningful utilization management. Oklahoma has a full-blown member services operation for its PCCM program that takes enrollee calls day and night. Arkansas only credentials and contracts with providers that meet the state's MCO-like expectations, not merely any licensed warm provider body, the old Medicaid standard. North Carolina surveys its PCCM enrollees. Florida recently launched several comprehensive disease management programs that, by God, are designed to track down and get enrollees in regimens for their chronic diseases.