KFF May 1, 2024
Managed care is the dominant delivery system for Medicaid enrollees. The latest national Medicaid managed care enrollment data (from 2021) show 74% of Medicaid beneficiaries were enrolled in comprehensive managed care organizations (MCOs). The Centers for Medicare and Medicaid Services (CMS) continues to highlight the role MCOs can play in helping people eligible for Medicaid use and keep their coverage during the unwinding of the continuous enrollment requirement. While managed care is the dominant Medicaid delivery system, states decide which populations and services to include in managed care arrangements, which leads to considerable variation across states. Additionally, while state requirements for Medicaid managed care plans can be tracked, plans have flexibility in certain areas, including in setting provider payment rates,...
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