Frequently Asked Questions
Questions Frequently Asked by Providers:
Q: 1. How will Family Care affect service providers?
A: Northeast Wisconsin Family Care is
responsible for developing a network of providers suitable to serve
members throughout the seven county area. Current providers,
including counties, may wish to contract with this Managed Care
Organization. The network will focus on offering needed and covered
services for an increasing number of members as waiting lists are
eliminated. Contracts will be awarded based on members’ needs and
the provider’s qualifications, ability, skill and licensure. Members
are part of the team that is involved in service decisions and
choice of providers.
Q: 2. What if a provider does not want to
be a Family Care provider?
A: Providers can choose whether or not they wish to contract with
NEW Family Care. Because Family Care is an entitlement for all financially and functionally
eligible people including people on wait lists, there will be a need
for an increased number of providers.
Q: 3. Will there be enough service
providers to meet the increased number of consumers receiving
services?
A: Northeast Wisconsin Family Care is
responsible for developing an adequate network of providers. Our
planning process includes identifying gaps in services to meet
members’ needs and if there are not enough providers, resource and
capacity development will be a priority throughout implementation of
the District.
Q: 4. How will provider rates be set?
A: Northeast Wisconsin Family Care will
contract with a variety of providers to serve its members’ needs,
and rates are determined by the needs of the members and the
cost-effectiveness of the services provided. Each managed care
organization receives a payment in the form of a per-person, or ‘capitated,’
rate from the state, which it uses to pay for all agency costs, the
vast majority of which is services to its members. Funds for
provider rates are funded from the capitated rate payments.
