10 Things to Know about Medicaid Managed Care

KFF Health News September 6, 2019
Elizabeth Hinton, Robin Rudowitz, Maria Diaz, and Natalie Singer

Medicaid is the nation’s largest public health coverage program, though many Medicaid beneficiaries now receive their care through privately-held managed care companies. This brief describes key themes related to the use of comprehensive, risk-based managed care in the Medicaid program and highlights data and trends related to MCO enrollment, service carve-ins, spending, MCO parent firms, and state and plan activity related to quality, value-based payments, and the social determinants of health.

39 states contract with comprehensive managed care organizations (MCOs). More than two thirds (69%) of Medicaid beneficiaries nationwide receive care through MCOs, and nearly half of those are covered by six for-profit insurers.