1. RHODE ISLAND MEDICAID Managed Care for the Child Welfare Population
Patrick Tigue, Medicaid Director
November 2018

2. History of Medicaid Managed Care in R.I.
Rhode Island began providing Medicaid coverage through managed care in 1994 with the creation of RIte Care. The program initially served low-income families and children but now serves about 272,000 people across child welfare; aged, blind, disabled; duals; and expansion populations. Enrollment is mandatory for most.
Participating Plans
Neighborhood Health Plan of Rhode Island
Tufts Health Public Plan
United Health Care Community Plan
Covered Services
Acute, primary and specialty care, pharmacy, and behavioral health

3. Foster Care
Children in foster care were the first population brought into managed care following RIte Care establishment
All plan contracts are equipped to provide services to children with special health care needs, including children in foster care. However, all children in foster care are served through one plan (Neighborhood)
Medicaid maintains oversight of the health plan + coordinates with the state’s Department of Children, Youth and Families (DCYF) to ensure children’s needs are met

4. Oversight Meet monthly with the health plan to review performance
Meet monthly with DCYF to ensure alignment of goals + address any issues with care for foster children
Share real-time data between health plan + DCYF caseworkers to ensure safe, timely transitions
Behavioral health plan care managers + DCYF caseworkers routinely coordinate, plan for care

5. Facilitates better relationships among care managers
Benefits of Specialized Plan
Ensures greater accountability + focus on the specific population’s needs
Incentivizes plan to invest in building capacity + expertise to serve the population
Facilitates better relationships among care managers

6. Limitations of Specialized Plan
Continuity of care issues
Children cycle in and out of DCYF custody
Providers may leave the plan’s network
Limited ability to impact care for children at risk of becoming DCYF-involved
Limited flexibility when plan capacity is not adequate for specific case issues

7. Questions