Research & Reports

MHPA’s research demonstrates the state and value of Medicaid managed care to help inform policy, deepen understanding of performance, and drive quality.  

April 2025 -

Infographic image

 

A Snapshot of Medicaid Managed Care

Medicaid managed care organizations (MCOs) partner with states to improve access to primary, preventive, and specialty services for the nation’s most vulnerable populations. The managed care model provides flexibility to address the local, diverse, and complex needs of Medicaid enrollees and improve health outcomes.

As state Medicaid agencies complete post-pandemic eligibility requirements, MCOs continue to play an important role in meeting the health care needs of Medicaid enrollees.

VIEW THE RESEARCH BRIEF

October 2024 -

 

https://medicaidplans.org/wp-content/uploads/2024/10/Research-Brief-The-Waiver-Effect-An-Exploratory-Analysis-of-Medicaid-Enrollment-Trends-in-the-Presence-of-Waivers-One-Year-into-Redetermination Screenshot

The Waiver Effect:
An Exploratory Analysis of Medicaid Enrollment Trends in the Presence of Waivers

New research from MHPA reveals that Medicaid Managed Care Organization (MCO)-specific waivers significantly impact enrollment during the unwinding of continuous enrollment. Our analysis of a full year of data shows that states utilizing two waivers experienced the lowest decline in net Medicaid enrollment (11.9% loss) compared to states with zero waivers (15.8% loss).

VIEW THE RESEARCH BRIEF

July 2024 -

Snapshot of Medicaid with Managed Care - UPDATED 

Medicaid managed care organizations (MCOs) partner with states to improve access to primary, preventive, and specialty services for the nation’s most vulnerable populations. The managed care model provides flexibility to address the local, diverse, and complex needs of Medicaid enrollees and improve health outcomes.

As state Medicaid agencies complete post-pandemic eligibility requirements, MCOs continue to play an important role in meeting the health care needs of Medicaid enrollees.

VIEW THE INFOGRAPHIC

January 2024 -

State of Medicaid Managed Care: A Closer Look at Managed Long-Term Services and Supports 

To better understand Managed Long-Term Services and Supports (MLTSS) programs, which vary widely in the populations and benefits included under managed care, Sellers Dorsey partnered with MHPA, the Association for Community Affiliated Plans (ACAP), and the National MLTSS Health Plan Association to release "The State of Medicaid Managed Care: A Closer Look at MLTSS." The report features a:

  • Breakdown of key program features of states at various points in the development of MLTSS programs.

  • Survey of states currently operating an MLTSS program on program priorities, dual eligible integration, and more.

  • In-depth look at states' experiences with MLTSS programs including the PHE, Dual Eligibles, Workforce Challenges, and more.

VIEW THE REPORT

October 2023 -

On the Ground Enrollment: Results from a National Survey of Medicaid MCO Experiences During Redetermination

As states began redetermining Medicaid eligibility this spring and summer - the first time in three years - following the end of Medicaid’s continuous enrollment provision, new research by Medicaid Health Plans of America (MHPA) details the strategic engagement tactics deployed by Medicaid managed care organizations (MCOs) to ensure those eligible for Medicaid maintained access to quality, affordable health care and limit disruptions caused by coverage loss. The research also identifies priority policy or process changes that would enable more effective support of Medicaid members.

VIEW THE REPORT

April 2023 -

A Snapshot of Medicaid with Managed Care

Medicaid managed care organizations (MCOs) partner with states to improve access to primary, preventive, and specialty services for the nation’s most vulnerable populations. The managed care model provides flexibility to address the local, diverse, and complex needs of Medicaid enrollees and improve health outcomes. At the same time, Medicaid MCOs must adhere to federal requirements pertaining to administrative costs and profits. This infographic provides a general overview of Medicaid managed care as of April 2023, prior to when the renewals process resumed following the end of the COVID-19 public health emergency and Medicaid’s continuous enrollment provision.

SEE THE STATISTICS