Health Affairs January 29, 2025
Michael Monson, Melanie Bella

Medicaid managed care has become the dominant form of Medicaid delivery in the United States, with 41 states (including Washington, DC), using managed care organizations (MCOs) to provide access to Medicaid. The use of this delivery mechanism has risen over time, reaching 75 percent of all individuals in the program as of 2021. However, managed care penetration is not equal across populations. As of 2021, only 52 percent of payments were going to MCOs.

The discrepancy between the percentage of payments made to MCOs and individuals enrolled in MCOs mostly has to do with certain populations being excluded from managed care, even in states that use it. Almost every state that has managed care enrolls nearly all of their...

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Topics: CMS, Govt Agencies, Insurance, Medicaid, States
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