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.
Click here for our Medicaid 101 series on YouTube.
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
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 […]
Examining the Role of External Quality Review in Managed Care Oversight and Accountability
March 13, 2025
Chapter 1 focuses on improving the managed care external quality review process. Managed care is the primary health care delivery approach in Medicaid, with 73 percent of beneficiaries enrolled in a comprehensive, full-risk managed care organization (MCO). With the growth of managed care, federal and state stakeholders have increasingly prioritized the effective oversight of Medicaid […]
March 2025 Report to Congress on Medicaid and CHIP
March 13, 2025
MACPAC’s March 2025 Report to Congress on Medicaid and CHIP contains three chapters of interest to Congress: (1) recommendations to improve the usability and transparency of the managed care external quality review process, (2) improvements on timely access to home- and community-based services (HCBS), and (3) ways to streamline Medicaid Section 1915 authorities for HCBS and […]