Medicaid Managed Care: What's Ahead in 2015

By: Alexander Dworkowitz | Deborah Bachrach | Robert D. Belfort
– Bloomberg BNA's Health Care Policy Report 

Managed care is the dominant delivery model in state Medicaid programs, and is rapidly growing with the Affordable Care Act bringing over 8 million new beneficiaries into Medicaid in 2014. Today, 39 states (including the District of Columbia)1 enroll beneficiaries in comprehensive managed care plans and more than half of all Medicaid beneficiaries are now covered through such plans.2 Medicaid managed care will enter a particularly dynamic period in 2015 as Medicaid enrollment surges, more services and populations move into capitated arrangements, states try to marry managed care with value-based purchasing initiatives, and the Centers for Medicare & Medicaid Services (CMS) issues the first new major Medicaid managed care regulation in a decade.

This article highlights emerging trends in Medicaid managed care and considers their implications for health plans, providers, states and beneficiaries.

Reproduced with permission from BNA's Health Care Policy Report, 23 HCPR 296, 02/23/2015. Copyright [1] 2015 by The Bureau of National Affairs, Inc. (800-372-1033) http://www.bna.com