10 Things to Know About Medicaid Managed Care
Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
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State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes
News ReleaseAs states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
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Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports
Issue BriefThis brief describes the Managed Care Program Annual Report (MCPAR), a relatively new, comprehensive report on state Medicaid managed care programs that includes plan-level data. It is aimed at improving state and federal managed care program monitoring, oversight, and transparency.
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Health Reform Hits Main Street
VideoThis short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.
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Medicaid Authorities and Options to Address Social Determinants of Health
Issue BriefSocial determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age. While there are limits, states can use Medicaid – which, by design, serves a primarily low-income population with greater social needs – to address social determinants of health. This brief outlines the range of Medicaid authorities and flexibilities that can be used to add benefits and design programs to address the social determinants of health.
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Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018
ReportThis report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and…
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States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019
ReportThis report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in…
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New Orleans Five Years After the Storm: A New Disaster Amid Recovery
Poll FindingThis comprehensive survey of the experiences of New Orleans residents is the third in a series conducted by the Kaiser Family Foundation since 2005. Five years after Hurricane Katrina, an increasing majority of the city’s residents says the rebuilding process is going well, but substantial majorities still report that the city has not recovered and feel the nation has forgotten them. The survey also finds the scope and immediacy of the Gulf oil spill weighing heavily on…
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CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions
Issue BriefOn April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.
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State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid
Issue BriefState Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system…