Exploring 19 States’ Medicaid Managed Care Data
As Medicaid spending and enrollment have grown in recent years, states have increasingly turned to managed care as a way to try to save money and improve delivery of medical services. Yet little is known about the number or types of services Medicaid beneficiaries get through managed care. Today’s WatchBlog shares some data we tracked down on service utilization by Medicaid beneficiaries and how you can explore the data yourself.
Under the managed care model, states typically pay what’s called a “managed care organization” a set amount of money for each Medicaid beneficiary. The MCO then provides a specific set of Medicaid-covered services. So what services are Medicaid managed care beneficiaries getting? The answer is not straight-forward. As you can see in the figure below, there is wide variation in the amount and types of services beneficiaries used in each of the 19 states we examined. The types of services used—such as an office visit or lab test—also varied considerably by how long people were enrolled in Medicaid managed care.
(Excerpted from GAO-15-481)
- the 19 states we examined;
- children vs. adults;
- type of service provided, including a range of procedures; and
- length of Medicaid enrollment, such as partial vs. full year enrollments, as well as ranges of months enrolled.
- Questions on the content of this post? Contact Carolyn Yocom at yocomc@gao.gov.
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