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  1. www.medicaid.gov › medicaid › managed-careManaged Care | Medicaid

    Learn about the health care delivery system that manages cost, utilization, and quality for Medicaid beneficiaries. Find out how states contract with different types of managed care organizations (MCOs) and implement initiatives to improve care for complex populations.

  2. www.definitivehc.com › managed-care-organizationManaged Care Organization (MCO) - Definitive Healthcare

    Learn what an MCO is, how it works, and its benefits for healthcare. Find out the four types of MCOs: PPO, HMO, POS, and EPO.

  3. www.kff.org › medicaid-managed-care-trackerMedicaid Managed Care Tracker - KFF

    This Data Collection, the Medicaid Managed Care Market Tracker, provides information related to risk-based Medicaid managed care organizations (MCOs) that provide comprehensive services,...

  4. www.medicaid.gov › medicaid › managed-careManaged Care Entities | Medicaid

    Federal Managed Care regulations at 42 CFR 438 recognize four types of managed care entities: Managed Care Organizations (MCOs) Comprehensive benefit package. Payment is risk-based/capitation.

  5. www.kff.org › medicaid › issue-brief10 Things to Know About Medicaid Managed Care - KFF

    • Elizabeth Hinton
    • Today, capitated managed care is the dominant way in which states deliver services to Medicaid enrollees. States design and administer their own Medicaid programs within federal rules.
    • More than two-thirds (72%) of all Medicaid beneficiaries received their care through comprehensive risk-based MCOs. As of July 2020, 57 million Medicaid enrollees received their care through risk-based MCOs.
    • Children and adults are more likely to be enrolled in MCOs than adults ages 65+ and people eligible through disability; however, states are increasingly including beneficiaries with complex needs in MCOs.
    • In FY 2021, payments to comprehensive risk-based MCOs accounted for over half of Medicaid spending. In FY 2021, state and federal spending on Medicaid services totaled over $728 billion.

  6. oig.hhs.gov › featured-topics › managed-careManaged Care | HHS-OIG - Office of Inspector General

    Aug 27, 2024 · Managed Care is quickly becoming the predominant payment system for people enrolled in Medicaid and Medicare. OIG is providing oversight to protect people enrolled in Medicare Advantage and Medicaid Managed Care and to safeguard taxpayer dollars.

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  8. www.medicaid.gov › medicaid › managed-careProfiles & Program Features | Medicaid

    These Managed Care State Profiles and State Program Features reflect the most recently available managed care program information.

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