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
Children and Youth in Foster Care Enrolled in Medicaid Managed Care
September 24, 2026
In response to the Commission’s continued interest in how states use managed care plans to serve children and youth in foster care, MACPAC is examining how states use general and specialty managed care plans to serve children and youth in foster care, including services offered, oversight, and data collection. MACPAC conducted a federal policy scan […]
State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Plans
June 15, 2026
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 […]
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 […]