The value of Medicaid managed care

In this fourth and final video from our Medicaid on-demand training series, we explore the value of Medicaid managed care and how this model supports improved care delivery, financial stability and member outcomes.

Managed care has become the predominant way states deliver Medicaid services. By working with managed care organizations (MCOs), states contract with private health plans to administer benefits and manage care for enrolled individuals, often through comprehensive, risk-based arrangements.

This video addresses questions including:

• What is Medicaid managed care?
• How do states use waivers and state plan amendments to implement managed care?
• What is a per member per month rate, and how does it work?
• How do MCOs coordinate care and ensure provider accountability?
• What is the medical loss ratio, and why does it matter for care quality?

You’ll also learn how MCOs assume financial risk, how they support integration of services like behavioral health and pharmacy services and why this model is now used to serve over 75% of Medicaid enrollees nationwide.

Watch the video to understand how managed care is reshaping Medicaid and creating more efficient, coordinated and outcomes-focused systems.