Through the end of August 1996, HCFA approved 38 Freedom of Choice waivers. Section 1115 demonstrations allow states to test new approaches to benefits, services, eligibility, program payments, and service delivery, often on a statewide basis. These approaches are frequently aimed at saving money to allow states to extend Medicaid coverage to additional low-income and uninsured people. When all 13 are implemented, 2.2 million previously uninsured individuals are expected to receive health coverage. As the number of beneficiaries enrolled in managed care plans has increased, the Clinton Administration has been working closely with states, insurers, health care professionals, and consumers to assure the quality of care provided in that setting.
Several initiatives are already underway.
The new measures will help plans to improve the quality of their care and support efforts to improve the health status of beneficiaries. This summer, Facct endorsed three condition-specific outcome measures, diabetes, depression and breast cancer, which HCFA is interested in testing. In July 1993, QARI issued A Health Care Quality Improvement System for Managed Care, providing states with a broad range of Federally-recommended guidelines for building and operating quality assurance and improvement systems. These guidelines were tested in three states in 1993-95 by the Kaiser Family Foundation and the results were issued in 1995 through the National Academy for State Health Policy's Quality Improvement Primer for Medicaid Managed Care. Philip R. Lee, M.D., and is made up of representatives from operating and staff divisions of the Department of Health and Human Service.