The debate about public programs like Medicaid has always been partly a debate about the role of government in health care. Yet, new data available on KFF’s Medicaid Managed Care Market Tracker illustrates the substantial role private insurers now play in the program. Thirty-nine states contract with comprehensive managed-care organizations (MCOs), many of which are privately-held companies. More than two thirds (69%) of Medicaid beneficiaries nationally now receive care through MCOs, and nearly half of those beneficiaries are covered by six for-profit insurers.
KFF’s tracker now features the latest available data about Medicaid managed care to allow comparisons across states and provide a national snapshot of the market. It includes state-level, MCO-level, and parent firm-level information related to comprehensive Medicaid MCOs across the country that can help policymakers working to ensure Medicaid beneficiaries get the care they need. It also provides data on enrollment and spending; ownership; and parent firm participation across states Medicaid programs.
Accompanying the tracker is a new KFF brief highlighting key facts about states’ use of comprehensive, risk-based managed care in Medicaid, including data and trends related to enrollment, state spending, and market share, as well as activities related to quality, value-based payments, and social determinants of health.