The Alabama Legislature passed a sweeping revision to Medicaid that replaces the way the program delivers and pays for care with regional managed care operators.

Under the legislation passed Tuesday, the State Medicaid Agency will no longer bear financial risks but will instead assume the role of contract administrators. Savings of $50 million to $75 million over five years and future cost containment is expected.

Privately owned Regional Care Organizations won't deal directly with patients, but will contract directly with doctors to provide care.

The organizations will be required to improve the quality of care and provide better access to services. If they're successful, the agencies will realize profits.

No current services will be eliminated. Nursing home patients, dental, mental health and pharmacy programs will not be affected until 2016.