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

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 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 our study. Staff then presented draft policy recommendations to address the opportunities to improve managed care plan accountability. The proposed 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.