States are responding to record-breaking enrollments in their Medicaid plans by expanding their use of private managed-care insurance plans to control costs, according to a survey of the programs by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.
Medicaid managed care expands
State use of comprehensive managed-care plans, in which private plans provide a network of providers for their Medicaid enrollees who agree to accept the patients and to ensure timely access to care, has grown to 66% of those beneficiaries, nationally, according to the survey.
The expansive use of managed care, according to the survey, is increasingly likely to include Medicaid beneficiaries with more complex needs, including children with “special health care needs,” and seniors and people with disabilities. Additionally, half of the states report some enrollment of beneficiaries eligible for both Medicaid and Medicare—who are more likely to have complex medical conditions—in managed care.
“States expect to rely increasingly on managed care in the near term,” noted the report.
One looming development that could complicate states' growing use of managed care in their Medicaid programs is the planed expansion of Medicaid eligibility by at least 16 million more people under provisions of the Patient Protection and Affordable Care Act. Only about half of the states with comprehensive managed-care plans reported that their plans have or could develop enough capacity to absorb that increased Medicaid enrollment.
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