When large expansions of Medicaid enrollment into managed care began in the mid-1990’s, the focus was on children and families. Historically, enrollees with disabilities and enrollees age 65 and older were generally excluded or exempted from enrollment in managed care and received their Medicaid benefits through either fee for service or small demonstrations or voluntary programs that attracted few enrollees.
However, there is growing interest among states to extend managed care to enrollees with disabilities and enrollees age 65 and older. Both groups tend to have more complex health care needs and higher costs than children and families. In addition, many seniors and some Medicaid enrollees with disabilities also have Medicare which may complicate coordination and state choices. Section B of MACPAC’s June 2011 report provides information about Medicaid managed care enrollees, their share of Medicaid spending, and how states address managed care for dually eligible enrollees and those with disabilities.
Publication Type: Reports to Congress