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Medicaid Managed Care Market Tracker

More than half of all Medicaid beneficiaries nationally receive most or all of their care from risk-based managed care organizations (MCOs) that contract with state Medicaid programs to deliver comprehensive Medicaid services to enrollees. Although not all state Medicaid programs contract with MCOs, a large and growing majority do, and states are also rapidly expanding their use of MCOs to reach larger geographic areas, serve more medically complex beneficiaries, deliver long-term services and supports, and, in states that have expanded Medicaid under the Affordable Care Act (ACA), to serve millions of newly eligible low-income 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 to comprehensive Medicaid MCOs. (Information related to prepaid ambulatory health plans (PAHP), prepaid inpatient health plans (PIHP), and Programs of All-Inclusive Care for the Elderly (PACE), and data on enrollment in MCOs through states’ capitated financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, are not included in this Tracker.) To shed light on broader market dynamics, the Tracker also provides data on parent firm participation in other health insurance market sectors. The Medicaid MCO enrollment data included in this Tracker were obtained from managed care enrollment reports posted on state Medicaid websites or, in some cases, provided to us by state Medicaid officials. Not all states with Medicaid MCOs currently post this information; as additional states make their MCO enrollment data available, we will add these data to the Tracker.

about this data collection

This Data Collection, the Medicaid Managed Care Market Tracker, provides information related to risk-based Medicaid managed care organizations (MCOs) that provide comprehensive services, including acute care services and, in some cases, long-term services and supports as well, to Medicaid enrollees. In addition, the Tracker provides information on parent firms that own Medicaid MCOs in two or more states. Data on other forms of Medicaid managed care, including prepaid ambulatory health plans (PAHPs), prepaid inpatient health plans (PIHPs), primary care case management (PCCM), and Programs of All-Inclusive Care for the Elderly (PACE) are not included in this Data Collection. For more information on those managed care programs, please see other Medicaid Managed Care data on State Health Facts.

The data in this Tracker derive from numerous sources, including reports and other information available on the websites of state Medicaid agencies, MCOs, and parent firms; reports issued by the Centers for Medicare & Medicaid Services (CMS); proprietary data (by permission); and other sources. Additional detail on the sources for each indicator is provided below:

Medicaid Managed Care State-Level Data

Medicaid MCO-Level Data

Parent Firm-Level Data

The data in the Medicaid Managed Care Tracker are current to the date or period specified in the sources for each table.

The information in this Tracker is public information and may be reproduced with appropriate citation.