States are increasingly relying on Medicaid health plans to promote high-quality, coordinated care for their growing Medicaid populations. More than 43.5 million low-income individuals – representing nearly 66 percent of total Medicaid enrollment – rely on private health plans for their Medicaid coverage.
These plans provide a variety of services to meet the unique needs of their beneficiaries, including programs to coordinate care for people with multiple chronic conditions; outreach and education initiatives to promote prevention and healthy living; and efforts to facilitate beneficiaries' access to non-medical support, such as social services or transportation.
Medicaid health plans achieve cost savings for states while outperforming the fee-for-service program on key quality measures. Recent research has shown that by coordinating medical and pharmacy benefits, Medicaid health plans saved $2.06 billion in state and federal expenditures in 2014 alone. Moreover, beneficiaries enrolled in Medicaid health plans are more likely to receive preventive services, as well as have fewer hospital admissions, and better access to primary care than the FFS program.
This paper examines 35 states and the District of Columbia that made use of the MCO capitation contracting model in their Medicaid program, transferring risk for medical costs to coordinate care for at least some of their Medicaid beneficiaries.
States in which Medicaid plans manage prescription drug benefits are realizing large-scale savings, according to a new analysis by The Menges Group.
explains the innovative approaches that 30 health plans have taken to providing
easily understood, actionable health and benefits information for consumers.
As state Medicaid programs struggle to deal with rising medical costs and expanding populations, the targeted programs and services offered by Medicaid managed care plans are enhancing patients’ quality of life, improving health outcomes, and providing better value for taxpayers, according to a new report from America’s Health Insurance Plans (AHIP)
In this report—an update to AHIP’s 2005 Innovations in Medicaid Managed Care book—we provide details about 17 health plan initiatives dedicated to improving the health and well-being of Medicaid beneficiaries.
AHIP hosted a Capitol Hill briefing on how Medicaid health plans improve access and quality of care for beneficiaries while providing cost savings to states. The briefing featured presentations from four Medicaid health plan executives.
This report by America’s Health Insurance Plans
(AHIP) analyzes enrollment and participation trends in Medicaid managed care
plans. Of the 50.5 million Medicaid beneficiaries nationwide, 23.9 million were
enrolled in a Medicaid health plan as of June 30, 2009, an increase of 2.4
million since 2008.
Kaiser Health News/USA Today examine how states are turning to Medicaid managed care plans to provide care for long-term care patients.
This synthesis of research by America’s Health Insurance Plans (AHIP) demonstrates that Medicaid health plans provide high quality accessible care to beneficiaries and value to states.
Health insurance plans are implementing a multitude of creative programs to improve quality and efficiency in Medicaid.
According to the Lewin Group's review of 14 studies, Medicaid managed care has saved states up to 19% compared with fee-for-service Medicaid.