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Medicaid Managed Care Market Tracker

More than half of all Medicaid beneficiaries nationwide receive most or all of their care from risk-based managed care organizations (MCOs) that have state contracts to deliver comprehensive services to enrollees. Not all state Medicaid programs contract with MCOs, but a large and growing number are doing so, and states are also rapidly expanding their use of risk-based managed care to reach larger geographic areas, to serve more medically complex beneficiaries, and to provide long-term services and supports. In addition, states expanding Medicaid under the Affordable Care Act (ACA) are relying largely on comprehensive MCOs to serve the millions of newly eligible adults.

To enhance understanding and analysis of the Medicaid managed care market, the Medicaid Managed Care Market Tracker provides state-level, MCO-level, and parent firm-level information related directly, or by extension, to comprehensive risk-based MCOs in Medicaid. It also provides data on parent firm participation in other insurance markets, which shed light on broader market dynamics. As we launch the Tracker in December 2014, 39 states (including DC) have contracts with Medicaid MCOs and 19 of these states make MCO enrollment data publicly available on their websites. It is noteworthy that over 90% of all Medicaid beneficiaries live in the 39 MCO states. Two-thirds of all Medicaid beneficiaries live in the 19 states that report their MCO enrollment, and beneficiaries enrolled in MCOs in these 19 states account for over 45% of all Medicaid beneficiaries nationally. MCO enrollment data for the other states with comprehensive MCOs will be added as the states make their data available.  Key findings on Medicaid managed care based on analysis of data in the Tracker can be found here.

The idea for the Medicaid Managed Care Market Tracker, important conceptual work underlying it, and valuable information sources were developed by Community Catalyst. The Kaiser Family Foundation acknowledges Community Catalyst for these contributions.

For more information on how to track data:


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Categories: Medicaid Watch