More than two-thirds of all Medicaid beneficiaries nationally receive most or all of their care from risk-based managed care organizations (MCOs) that contract with state Medicaid programs to deliver comprehensive Medicaid services to enrollees. Although not all state Medicaid programs contract with MCOs, a large and growing majority do, and states are also rapidly expanding their use of MCOs to serve more medically complex beneficiaries, deliver long-term services and supports, and, in states that have expanded Medicaid under the Affordable Care Act (ACA), to serve millions of newly eligible low-income adults.
To enhance understanding and analysis of the Medicaid managed care market, the Medicaid Managed Care Market Tracker provides state-level, MCO-level, and parent firm-level information related to comprehensive Medicaid MCOs. The 2017 state- and plan-level Medicaid MCO enrollment data included in this Tracker come from the Centers for Medicare and Medicaid Services’ (CMS) Medicaid Managed Care Enrollment Reports. Using this report source allows us to show MCO enrollment data for all states that contract with comprehensive risk-based MCOs. We will continue to post more current MCO plan-level enrollment data for a subset of states that post this data on their state Medicaid websites.
Separate from the comprehensive Medicaid MCO-related indicators, the tracker also includes a collection of other broader managed care state-level data which show enrollment in any “managed care” models including Primary Care Case Management (PCCM) programs, prepaid ambulatory or inpatient health plans (PHPs), and the Program for All-inclusive Care for the Elderly (PACE).
Date: August 07, 2019