State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Organizations: Policy Options

Managed care is the predominant delivery system in Medicaid. As such, the effective oversight of Medicaid managed care programs is a priority for stakeholders. This session continued the Commission’s examination of the use of managed care accountability tools. It reviewed key findings from stakeholder interviews and analysis of the Managed Care Program Annual Reports available from the Centers for Medicare & Medicaid Services, identifying the opportunities and barriers to effective oversight that emerged from MACPAC’s study. Staff then presented policy options to address the opportunities to improve Managed Care Organization accountability, with a focus on equalizing the authorities across fee-for-service Medicaid and managed care and on improving stakeholders’ ability to leverage available managed care plan data.