Medicaid Managed Care Delivers Value and Efficiency to States
Findings from the literature demonstrate that Medicaid managed care improves quality, enhances access to care and individuals’ experience, and helps states manage costs. Medicaid managed care offers a successful foundation on which to build future Medicaid reform efforts.
Today, more than 60 percent of Medicaid beneficiaries are enrolled in managed care plans, and states continue to expand enrollment in plans. Among other goals, states are turning to managed care to improve care for high-cost, high-need populations such as individuals who need long-term services and supports. Enrollment in managed care also grew following the Affordable Care Act’s expansion of Medicaid to low-income working age adults.
As federal and state policymakers consider approaches to reform and modernize the Medicaid program, it is important to explore whether existing managed care programs have delivered the expected innovations, improvements in outcomes, and cost savings that states expected.
Related Public Policy Research
Continuity of Medicaid Coverage Improves Outcomes for Beneficiaries and States
Continuous coverage improves beneficiaries’ health, lowers spending per person, and eases administrative burden for states. Those with disruptions are likelier to have unmet medical needs.
The Impact of Medicaid Quality Rating Systems
Little is known about how quality tools impact managed care but the experience of other programs suggests that as tools evolve, their influence on behavior and plan quality could grow.
Hidden Benefits: The Value of Medicaid Managed Care Networks
Medicaid MCOs employ an array of network enhancing strategies—such as technology-based innovations and value-based payment—to increase access to and quality of care for beneficiaries.