June 2011 Report to Congress: The Evolution of Managed Care in Medicaid

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June 2011

Understanding Medicaid managed care arrangements is essential to determining how the program fits into U.S. health care. The Commission’s June 2011 report to Congress provides a baseline description of managed care in Medicaid today, both nationally and at the state level. The majority of states use managed care, and these arrangements are likely to become even more prevalent over the coming years. However, Medicaid managed care programs vary considerably among states, as well as within states, across different populations, and geographic locations.

The report describes the enrollees in Medicaid managed care, including children and families, enrollees with disabilities, and those who are dually eligible for Medicaid and Medicare. It also examines the current status of enrollment, payment, access, and quality measurement and improvement, as well as the consistency, availability, and timeliness of data needed to adequately evaluate managed care programs and ensure program accountability.

Publication Type: Reports to Congress

Report Chapters

Tags: access, capitation, carve in/carve out, children, dually eligible beneficiaries, eligibility, encounter data, enrollment, full risk managed care, limited benefit plans, managed care, payment, pregnant women, primary care case management, program integrity, quality measures, rate setting, risk adjustment, spending