By Anne Swerlick, Senior Policy Analyst, Florida Policy Institute Experts agree that to reduce health disparities, you first need to know where they exist. The collection of health plan performance measure data, such as timely prenatal care and well-child check-ups, broken down by demographic factors like race and ethnicity is essential for developing targeted health […]
Discussions have begun on the possibility of enacting a scaled-down version of the Build Back Better legislation. Any agreement that includes new federal spending will also require pay-fors (a/k/a offsets) either in the form of spending reductions or tax increases, or both. In Medicaid, responsible pay-fors—i.e., policy changes that the Congressional Budget Office will score […]
There is no shortage of acronyms or initialisms in government agencies and programs and Medicaid is no exception. The Medicaid and CHIP Payment and Access Commission or MACPAC (one of our favorite acronyms) devotes an entire glossary to them. The most prominent initialism in Medicaid policy discussions these days is SDOH: social determinants of health, […]
Over 32.8 million children are covered by Medicaid, and the large majority are enrolled by their state Medicaid agencies in managed care organizations (MCOs). In exchange for monthly capitation payments, the MCOs contract with the state Medicaid agency to furnish covered services through networks of providers. These arrangements, in 40 states and the District of […]
Last week, California’s Medicaid agency issued a Request for Proposals (RFP) to provide managed health care services to program beneficiaries. This is not just another Medicaid RFP. California is far and away the nation’s largest Medicaid managed care market. As of September 2021 the state Medicaid agency contracted with 24 managed care organizations (MCOs) to […]
The Q4 2021 earnings reports are in, and the five largest companies in the Medicaid managed care market—CVS Health, Anthem, Centene, Molina, and UnitedHealth Group—did very well, thank you very much. CVS Health made $17.3 billion last year; Anthem, $7.5 billion; Centene, $1.8 billion; Molina, $1.0 billion; and UnitedHealth Group $24.0 billion. Not all of […]
