Recently, the Centers for Medicare & Medicaid services (CMS) released a wealth of information on Medicaid managed care, including guidance on managed care contracts and state-by-state profiles.

The updated website section includes an overview of managed care delivery systems and regulations. In addition, the technical support tab provides a state guide to CMS criteria for managed care contract review and approval, a rate setting consultation guide, and an encounter data toolkit. CMS outlines standards used to review and approve state contracts with managed care organizations (MCO), prepaid inpatient health plans (PIHP), prepaid ambulatory health plans (PAHP), primary care case managers (PCCM) and health insuring organizations (HIO).

CMS’ state profiles provide a detailed breakdown of Medicaid managed care program features for all states. The Managed Care State Profiles include basic information on a state’s Medicaid managed care program (major program type and name) in addition to which populations are enrolled (e.g., children and/or low-income adults), Medicaid services covered in capitation, participating plans or organizations, and quality/performance incentives (e.g., participation in HEDIS and/or CAHPS).

Additional resources supplement the information provided in CMS’ new publications. NHeLP’s publication A Guide to Oversight, Transparency, and Accountability in Medicaid Managed Care offers guidance on federal Medicaid managed care monitoring and oversight requirements. Kaiser Family Foundation’s Medicaid Managed Care Market Tracker is an interactive tool that analyzes data for 39 states that contract with MCO’s, including “state- and plan-specific information on enrollment and spending; MCO quality; MCO ownership by parent firms; and parent firm participation across insurance markets nationally.”

Given CMS is slated to release new Medicaid managed care regulations in the coming months, it’s great to have these resources bookmarked for informative and in-depth analyses of state managed care programs.