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

Chapter 3 offers recommendations to improve managed care plan accountability. Managed care is the predominant Medicaid delivery system in most states. Although the Centers for Medicare & Medicaid Services and states have made efforts to strengthen oversight of managed care programs, little is known about the accountability tools state Medicaid agencies use to ensure managed care plans comply with contract requirements and meet performance expectations. 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.