State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans: Draft Chapter

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. Staff reviewed key findings from the draft chapter for the June 2026 report to Congress, identifying the opportunities and barriers to effective oversight that emerged from MACPAC’s study. Staff then presented the two policy recommendations to address the opportunities to improve managed care plan accountability. The recommendations seek to improve the usability of managed care performance data and provide states with additional guidance and tools to more effectively assess and oversee plan performance.