Managed Care

Managed Care

Medicaid Managed Care Procurement: Opportunity for Transparency?

In most states, the responsibility for ensuring that children enrolled in Medicaid receive needed services rests with managed care organizations (MCOs).  They are stewards for millions of children and billions of Medicaid funding intended to meet children’s health care needs.  Yet there is little transparency about how individual MCOs are performing for children.  The logical […]

Redirecting Medicaid MCO Gains to Offset Network Provider Losses in the Time of COVID-19

2020 Q2 marked the arrival of the coronavirus pandemic, stay-at-home orders, school closures, social distancing, and a recession.  Families put off going to the doctor’s office for routine, non-emergency care.  Primary care physician practices and clinics that bill for each visit saw sharp drops in their revenues as patients stayed at home (pediatricians’ offices were […]

COVID-19, State Budget Deficits, and Medicaid Managed Care

The COVID-19 pandemic has unleashed not just death, but also massive unemployment and a steep recession.  Among the economic casualties are state budgets, which have been knocked badly out of balance by the resulting drop in revenues and the prospect of increased enrollment in Medicaid and other safety net programs.   Among those spared from the […]

Taxing Medicaid Managed Care to Mitigate Medicaid Cuts

In many states, Medicaid is under budgetary siege.  The steep recession brought on by the COVID-19 pandemic has led to large revenue shortfalls and budget deficits, most notably an estimated $54 billion in California for the fiscal year ending June 30 and the next.  States must balance their budgets, and they have only a few […]