Managed Care
Managed care is the primary Medicaid delivery system in more than half the states. States have incorporated managed care into their Medicaid programs for a number of reasons, including:
- Managed care provides states with some control and predictability over future costs.
- Compared with fee for service, managed care can allow for greater accountability for outcomes and can better support systematic efforts to measure, report, and monitor performance, access, and quality.
- Managed care programs may provide an opportunity for improved care management and care coordination.
More than half of federal and state Medicaid spending is on managed care. The proportion continues to grow each year. MACPAC annually compiles updated information on managed care spending and enrollment.
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Learn More about These Topics
- Managed care’s effect on outcomes
- Monitoring managed care access
- Medicaid managed care payment
- Data for program accountability and policy development
- Enrollment and spending on Medicaid managed care
- Managed care program integrity
- Key federal program accountability requirements in Medicaid managed care
- Types of managed care arrangements
- Enrollment process for Medicaid managed care
- Managed care overview
Featured Publications
Automation in Medicaid Prior Authorization: Recommendations
May 7, 2026
Prior authorization (PA) is the multi-step process by which health care payers require medical providers to request and receive approval before providing certain items, services, or medications. PA is widely used in Medicaid managed care and fee for service. The Commission conducted a study to understand the extent to which states, managed care plans, and […]
State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans: Draft Recommendations
March 5, 2026
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 […]
State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Organizations: Interview Findings
December 11, 2025
Managed care is the predominant delivery system in Medicaid. As such, oversight of Medicaid managed care programs is a priority. This session continues our work on the use of managed care accountability tools. It provided the background and federal requirements for oversight and then described themes from stakeholder interviews across three key areas: procurement and […]