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The Value Of Medicaid Managed Care

posted by AHIP

on November 11, 2021

Overview

It’s well established that Medicaid and CHIP (the Children’s Health Insurance Program) are essential parts of American health care. Comprising the largest health care program in the country covering approximately 1 in 4 Americans1, Medicaid and CHIP together help improve the health and financial security of over 82 million Americans, including more than two million veterans.

But what’s less widely appreciated is the key role Medicaid managed care organizations (MCOs) play in connecting Medicaid and CHIP enrollees with care and services, and transforming state policies and initiatives into programs that actually work. Medicaid agencies in 40 states have chosen to partner with Medicaid MCOs to coordinate care, drive quality, and increase the effectiveness of their Medicaid programs.

More than three-quarters of Medicaid enrollees are served by Medicaid managed care (MMC) programs, which are public-private partnerships between state governments and MCOs. And nearly 80% of Medicaid expansion enrollees are in MMC plans – a testament to the essential role that private plans play in ensuring better outcomes and a better patient experience.