In the beginning, there was fee-for-service (FFS). In this case, the beginning was 1965, when Medicaid (and Medicare) were enacted. FFS was the way that these public programs, as well as almost all private insurers, purchased health care. Fast forward to today. Propelled by an interest in budget predictability and federal policy changes giving them […]
Last week, MACPAC Commissioners voted to recommend that the Centers for Medicare & Medicaid Services post all state Managed Care Program Annual Reports (MCPARs) to the CMS website. The vote was unanimous: 17-0. The recommendation will be included in MACPAC’s March 2024 Report to Congress. At first glance, this may seem unremarkable, but on further […]
Last month, the Centers for Medicaid & CHIP Services (CMCS) issued a Center Informational Bulletin, “Medicaid and CHIP Managed Care Monitoring and Oversight Tools.” Among other items, this CIB discusses the Managed Care Program Annual Reports that state Medicaid agencies are required to submit to CMS. MCPARs are each state’s accounting of how each of […]
2023 marked an inflection point in the growth of Medicaid managed care. Enrollment in MCOs, which had climbed continuously in both 2021 and 2022 due largely to the continuous coverage policy in place during the Public Health Emergency, plateaued and then headed downward, due largely to the PHE unwinding. Much uncertainty remains as to how […]
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Our nation is in the midst of an ongoing maternal health crisis, one that particularly affects Black women. The causes are complex, the need to address them is urgent, and there is no single solution. One of many potential solutions that has not received enough attention is Medicaid managed care. Medicaid, the nation’s largest health […]
