Latest From Andy
Medicaid Managed Care: Transparency for Young Children in 12 States
Regular Say Ahhh! readers know that most children covered by Medicaid in most states received their coverage through private insurance companies, or managed care organizations (MCOs). We believe that publicly-available data on Medicaid managed care performance is key to fully understanding how well Medicaid MCOs are working for children. Consistent, MCO-level data helps identify gaps […]
Medicaid Managed Care and Early Childhood Development: A 12-state Scan
Summary and Key Findings The first five years of a child’s life are a period of rapid growth and development. During this time, frequent check-ups are essential to monitor a child’s progress so that if a problem is identified an intervention can occur before things get worse. Medicaid, a primary source of health care coverage […]
Transparency in Medicaid Managed Care: CMS Posts Annual MLR Reports
On November 1, CMS posted on its website Medical Loss Ratios (MLRs) for individual Medicaid managed care organizations (MCOs) in 2018, 2019, and 2020. These data come from the MLR Summary Reports that states are required to submit to CMS. This CMS action follows the posting on July 15 of the first tranche of Managed […]
Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q3 2024
Another quarter, another round of earnings reports from the “Big Five.” The story of Q3 continues the basic narrative of Q1 and Q2. For all but one of the companies that dominate the Medicaid managed care market, net Medicaid enrollment continued to decline, driven primarily by the PHE unwinding. There is one new wrinkle, however. […]
Medicaid Managed Care: Results of the PHE Unwinding for the Big Five in Q2 2024
The Q2 2024 earnings reports for the “Big Five” Medicaid managed care companies are in. They tell us that the PHE unwinding is winding down, but it’s still driving declines in Medicaid enrollment for the companies as a group. Here are the numbers. For the fifth consecutive quarter, beginning with Q2 2023, Medicaid enrollment for […]