Medicaid Managed Care

In a recently published issue brief, the National Association of Medicaid Directors (NAMD) provides an overview of Medicaid managed care. This brief covers the basics of what Medicaid managed care is, how it has grown over time, and how states and territories make decisions around delivery systems. It also dives into the core components of operationalizing managed care, including procurement, rate setting, and oversight. NAMD also discusses how Medicaid managed care is continuing to evolve, looking ahead at the potential impacts of market dynamics and regulatory changes on the quality, accessibility, and cost of care for Medicaid members.

This report presents information on managed care’s enrollment and spending. It explores the growth of enrollment in Medicaid Managed Care in the United States and the contributing factors. It also analyzes the fact that funding does not directly parallel enrollment, as the share of total Medicaid spending that went to managed care only grew from 15 percent to 37 percent between 1999 and 2012, despite enrollment growing from 63 percent to 89 percent during that same time period.