View the Latest: Managed Care
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Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations
ReportThis report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.
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Data Note: Medicaid Managed Care Growth and Implications of the Medicaid Expansion
Issue BriefMost states today rely heavily on risk-based managed care organizations (MCOs) to serve Medicaid beneficiaries. This Data Note discusses the current role of managed care in Medicaid and examines differences in managed care growth between states that expanded Medicaid to low-income adults under the Affordable Care Act (ACA) and states that did not expand Medicaid.
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Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans
Issue BriefJust over 35 million people are enrolled in Medicare Advantage in February 2026, an increase of 1.1 million since a year ago. The increase was largely driven by increased enrollment in special needs plans.
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10 Things to Know About Medicaid Managed Care
Issue BriefOur updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
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Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
Issue BriefMassachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…
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Kaiser Family Foundation/Field Institute Survey of Californians on the Health Care Initiatives, Propositions 214 and 216
ReportResults of two surveys that track Californian's knowledge of the two initiatives on the California Ballot, Propositions 214 and 216 (also known as the Patient Protection Acts) and attitudes towards them as the debate unfolds. The surveys were conducted from August 14-21, 1996 and from September 23-30, 1996. Also included with this material is data on how much is being spent on television advertising for and against the propositions and who is being reached by…
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Overview of Medicaid Managed Care Provisions in the Balanced Budget Act of 1997
Other Post11. Implications For Safety Net Providers Medicaid's transition from fee-for-service to managed care has enormous implications for safety net providers - those hospitals and clinics that deliver basic health care to large numbers of the uninsured. Medicaid has been a major revenue source for many of these providers, because it has reimbursed for the care and services they deliver to low-income patients who, without Medicaid coverage, generally would have no other source of payment. The…
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Medicaid Managed Care for Persons with Disabilities: A Closer Look
ReportThis report, Medicaid Managed Care for Persons with Disabilities: A Closer Look, presents an overview of the findings and summarizes the results of the case studies of Medicaid managed care programs that enroll persons with disabilities in four states: Florida, Kentucky, Michigan, and New Mexico. This report also draws from the findings of the 1998 national survey of state practices (Publication #2114) and focus groups of low-income disabled individuals (Publication #2152). This report addresses the…
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Medicaid Enrollment in 50 States: June 1997 to December 1999
ReportThis report provides current national and state-level data on the number of persons enrolled in Medicaid and CHIP. In addition to identifying recent trends in Medicaid and CHIP enrollment, this report also examines trends in the various eligibility categories within Medicaid. The report reveals that enrollment in Medicaid increased by 1.1 million individuals, or 3.6 percent, in December 1999 compared to the previous December. Executive Summary Report Link to December 2001 Data Update