We just wrapped our analysis of the market share of Medicaid managed care across the U.S. The findings? 68.8% of the 75 million Medicaid beneficiaries across the country have their health benefits provided through managed care plans – up from 60.5% in 2014.
But, the real findings are at the state level. There are two states with 100% of the Medicaid population enrolled in managed care – and eleven states with no Medicaid managed care enrollment. And, we found that 6.2% are enrolled in a health plan that provides LTSS and 0.9% are enrolled in a health plan that services only dual eligibles. You can check out your state’s number in The 2016 OPEN MINDS Medicaid Managed Care Update: A State-By-State Analysis. In this OPEN MINDS Market Intelligence Report, we analyze the Medicaid financing mechanisms by state, by population, and by service mix. This report provides detail on how services are provided to the broad range of Medicaid eligible beneficiaries on a state-by-state basis. The report is structured in three sections: Medicaid population in managed care including historical enrollment data; Medicaid managed care enrollment, FFS enrollment, and PCCM enrollment by state; and the Medicaid population enrolled in plans for dual eligibles by state.
The enrollment numbers are only part of the story. State Medicaid plans have adopted a wide variety of approaches to health promotion, cost management, and value-based purchasing. The variety in the state approaches is apparent in our recent coverage:
- Michigan To Launch All-Payer Patient-Centered Medical Home Initiative In 2017
- Ohio Medicaid Seeking Approval To Mandate Enrollment In A Health Savings Account
- Massachusetts Medicaid To Expand Addiction Treatment Benefit
- Pennsylvania Settles Class Action Lawsuit To Improve Access To Medicaid Autism Services & ABA
- Tennessee Medicaid To Implement Health Home Initiative In October 2016
- New York Pushes Back Managed Care Launch For Children In Foster Care Until Mid-2017
- CMS Approves First Three State Plans For New HCBS Person-Centered Settings – Kentucky, Ohio & Tennessee
- New Jersey Seeks Approval To Move I/DD Community Care Waiver To The Comprehensive Waiver
- Indiana Selects Anthem, CareSource, MDwise & Centene For Hoosier Healthwise/HIP MCO Contracts
- Oregon To Require Medicaid CCOs To Use Same Medical Loss Ratio For Expansion & Traditional Populations
- North Carolina Legislature Approves Medicaid Reform, Behavioral Health Carve-Out To End
- Iowa Medicaid Launches Managed Care Initiative April 1, 2016
If your organization is developing a strategy that involves the Medicaid market, what you have already learned is that every state’s system is different. There are wide differences in policy and practice between states – and in some states, between counties. For tools to understand the state-by-state variations in the Medicaid market, we’ve developed a series of market intelligence reports that provide the state-specific information you need:
- What State Medicaid Plans Carve-Out Addiction Treatment Services?
- How Many Consumers With I/DD Are Served By Medicaid HCBS Waivers & How Many Consumers Are On A Wait List?
- What Are The Medicaid Financing & Service Delivery Systems For The I/DD Population Receiving LTSS?
- What Addiction Treatment Services Are Covered By State Medicaid Programs?
- How Many Foster Care Children Are Enrolled In Medicaid Managed Care?
For a deeper dive into behavioral health, check out our Behavioral Health System State Profiles, which provide an in-depth analysis of each state’s Medicaid program and behavioral health system.
And to learn more about how one state is managing their shift to Medicaid managed care, join me on August 24 in San Diego for The 2016 OPEN MINDS California Management Best Practices Institute, where my colleague Steve Ramsland, Senior Associate, OPEN MINDS, will be joined by Wayne Clark, Ph.D., Executive Director, California Mental Health Services Authority to discuss, California’s Mental Health System: The Shifting Role Of Counties & Future Of Service Delivery In California.