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CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.

Federal Medicaid Outlays During the COVID-19 Pandemic

This data note analyzes federal Medicaid outlays in federal fiscal year (FFY) 2020, before and during the COVID-19 pandemic. Both annual and month-to-month growth rates in federal Medicaid outlays increased during the second half of FFY 2020, reflecting the onset of the pandemic and enhanced federal Medicaid funds.

Analysis of Recent National Trends in Medicaid and CHIP Enrollment

This data note looks at national and state-by-state Medicaid and CHIP preliminary enrollment data through July 2020, as states were still in the early stages of experiencing the health and economic effects of the coronavirus pandemic. After declines in enrollment from 2017 through 2019, preliminary data show that total enrollment grew to 75.5 million in July, an increase of 4.3 million from actual enrollment February 2020 (6.1%), right before the pandemic and when enrollment began to steadily increase.

The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election

As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers under this administration and how the November 2020 presidential election may impact this landscape.

10 Things to Know about Medicaid Managed Care

This brief describes key themes related to the use of comprehensive, risk-based managed care in the Medicaid program and highlights data and trends related to MCO enrollment, service carve-ins, spending, MCO parent firms, provider rates, and state and plan activity related to quality, value-based payments, and the social determinants of health. It also provides important context for the role MCOs play in the Medicaid program overall as well as during the current COVID-19 public health emergency and related economic downturn.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.