Beyond Medicaid Expansion: How 10 States Are Using Managed Care to Pursue Broader Health Care Reform
<p>Thirty-nine states contract with managed care organizations to provide care for their Medicaid beneficiaries. With the major growth in Medicaid enrollment since the Affordable Care Act, Medicaid expansion states in particular are increasingly relying on managed care — long a core feature of the state–federal program — to promote access to care while controlling costs.</p><p>A new study led by George Washington University professor Sara Rosenbaum examines how 10 states that have expanded Medicaid eligibility are adapting the modern tools of managed care purchasing to address the needs of their Medicaid beneficiaries and control costs. All the states share the challenges of perennially tight budgets, an influx of older adults in poor health, and cost pressures brought about by the opioid epidemic, among many others. </p>
<p>Rosenbaum and colleagues find that Medicaid officials view their health care purchasing role as a way to improve population health and increase the value of care, particularly for people who stand to benefit the most from better-managed care: people with chronic physical and mental health conditions, adults with addiction and substance use disorders, and children.</p>
<p>Read the brief and the authors’ companion post on <em>To the Point</em> to learn more about how states are evolving health care delivery and payment reforms in Medicaid, and why these will need time and a stable policy and regulatory environment to succeed. </p>