Kaiser Family Foundation Survey on State Medicaid Managed Care ...

ConclusionFor over 30 years, state Medicaid programs have relied increasingly on managed care. The number andtype of managed care arrangements used by states to deliver and finance care for Medicaid enrollees, aswell as the number and share of Medicaid beneficiaries enrolled in these arrangements, have grownsteadily. Growth in Medicaid managed care is expected to continue, driven by budget pressures tocontain Medicaid spending and by the influx of millions of new adult Medicaid enrollees when the ACAtakes full effect in 2014. As individual states look for new ways to improve health care quality, improveaccess, and achiever greater value for state dollars, there is much to be learned from the wide andevolving variety of Medicaid managed care program designs and experiences that can be found acrossthe country.This survey documents the diversity in current state Medicaid managed care approaches and activity,and state policymakers’ perspectives on the value of managed care as a strategy to improve access,quality, and accountability, and to promote cost-effective care and better health outcomes. As such, itprovides a baseline against which to measure and monitor what are likely to be importantdevelopments and trends in the coming years. However, an assessment of the impact of Medicaidmanaged care was beyond the scope of this project, which surveyed state policy officials alone andgathered largely descriptive information. Robust evaluations of Medicaid managed care will requireextensive analyses that include investigations of beneficiary and provider experiences and perspectives,as well. Particularly as states expand managed care to Medicaid beneficiaries with more complex needs,and as they determine the delivery systems that will serve millions more low-income Americans,evaluative research is crucial, as are federal and state efforts to assess performance, to developmechanisms to identify and resolve problems in meeting beneficiaries’ needs, and to assure high qualitycare for all those served by Medicaid through managed care.7