Thanks to Medicaid expansion and a greater push from some conservative states looking to reduce healthcare costs, enrollment of Medicaid and Children's Health Insurance Program (CHIP) beneficiaries in managed care will increase by 13.5 million by 2016, according to a new report from consulting firm Avalere Health.
In total, managed-care enrollment will increase from a previous 67% of Medicaid and CHIP enrollees in 2013 to 76% in 2016. Under Medicaid managed care, which is essentially an HMO for these beneficiaries, the state pays a fixed rate to the insurer, which administers payment for care.
New enrollment into Medicaid managed care will be particularly high in states that have expanded Medicaid. Those states had relied on managed care more heavily before ACA expansion. Also, newly eligible beneficiaries are predominantly enrolling in managed-care plans. Specifically, among states expanding Medicaid, the percentage of managed-care enrollees will rise from a previous total of 73% in 2013 to 79%, or 10.2 million new enrollees, in 2016.