News & Commentary

Managed care rules in Medicaid


Managed care is the rule rather than the exception when it comes to Medicaid programs.

As of July of last year, every state except Alaska, Connecticut, and Wyoming had some kind of managed care in place, according to a Kaiser Family Foundation survey of state Medicaid officials conducted last year.

Managed care penetration in Medicaid programs

*Percentages refer to the proportion of this segment of the Medicaid population covered through a managed care organization
Source: Kaiser Family Foundation, “Medicaid Moving Ahead in Uncertain Times,” October 2017

Thirty-nine states had contracts with comprehensive risk-based managed care organizations and in 29 of those states, 75% or more of the Medicaid beneficiaries were enrolled in one of those organizations, according to the survey.

A large majority (27 of 32) of the Medicaid expansion states used managed care organizations to cover newly eligible adults, and in 24 of them, 75% of the Medicaid newcomers were covered by the organizations.

Medicaid managed care is less common in the elderly and disabled population. Only 16 states have 75% or more of their Medicaid elderly and disabled population covered through managed care companies.

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