Medicaid

This brief takes a closer look at the five largest publicly traded companies operating Medicaid MCOs which account for half of Medicaid MCO enrollment nationally. Information and data reported in this brief come from quarterly company earnings reports, financial filings, and other company materials as well as from national administrative data.

This brief examines enrollment and financial data through the end of September 2024 from quarterly company earnings reports and calls, financial filings, and other company materials as well as from national administrative data.

Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.

In a new column, KFF President and CEO Drew Altman discusses how recent KFF focus groups with Trump voters on Medicaid show that voters were not expecting big Medicaid cuts from the Trump administration and worry about what the impact of potential cuts in federal Medicaid spending will be. As Drew writes: “Trump built a populist base of working people formerly in the Democratic party.” When details of specific Medicaid cuts emerge, tension could develop between “Trump and Republicans on the Hill who want to cut entitlement programs that now serve a significant part of Trump’s base.”

This analysis builds on previous KFF work by using Medicaid claims data for 2016-2019 to explore how prescriptions for opioids used to treat pain and those used to treat OUD or rapidly reverse overdose changed across states and Medicaid enrollee demographic groups over time.

Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the…

In light of worsening mental health among youth, strategies have been implemented to improve access to behavioral health services in recent years, including expanding school-based care for students. Leveraging Medicaid to improve and address gaps in school-based behavioral health services has been a key strategy in recent years as youth mental health concerns have grown. Provisions from the Safer Communities Act of 2022 utilize Medicaid to expand both school-based health care and other mechanisms of youth behavioral health care. This issue brief explores the implementation of these provisions from the Safer Communities Act thus far, with a focus on the guidance issued from CMS.

A growing number of states have added Medicaid coverage of non-traditional pregnancy-related care and services in recent years, such as doula services, lactation services, and home visiting programs, to promote better maternal and infant health outcomes and reduce racial/ethnic health disparities. This brief explores state strategies and challenges in promoting access to these services.

Managed care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer.  Roughly 3 out of 4 Medicaid enrollees receive care through managed care organizations and…