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

Managed caremodelTable 1: Medicaid Managed Care Models Operated by States, October 2010No. ofstatesComprehensive managed careStates with this modelMCOs only 17 AZ, CA, DC, DE, HI, MD, MI, MO, MN, MS, NE, NJ, NM, NV, OH, TN, WIPCCM only 12 AL, AR, IA, ID, LA, ME, MT, NC, ND, OK, SD, VTMCOs and PCCM 19 CO, CT, FL, GA, IL, IN, KS, KY, MA, NY, OR, PA, RI, SC, TX, UT, VA, WA, WVNon-comprehensive managed carePHPs 25 AL, AZ, CA, CO, DC, FL, GA, IA, ID, KS, MA, MD, MI, MS, NC, ND, NM, OR, PA,RI, TN, TX, UT, WA, WINo managed careFFS only 3 AK, NH, WYSource: KCMU/HMA <strong>Survey</strong> of Medicaid Managed Care, September 2011.About 66 percent of all Medicaid beneficiaries were enrolled in comprehensive managed carearrangements – either MCOs or PCCM programs – as of October 2010. States reported total Medicaidenrollment of 54 million in October 2010, including both fee-for-service and managed care. Of those 54million, 35.5 million, or 65.9 percent, were enrolled in either MCOs or PCCM programs (Table 2). MCOsaccounted for 26.7 million Medicaid beneficiaries, equivalent to three-quarters of comprehensivemanaged care enrollment and half (49.6 percent) of all Medicaid beneficiaries that month. PCCMprograms accounted for 8.8 million beneficiaries, or one-quarter of those in comprehensive managedcare and 16 percent of all Medicaid beneficiaries.Compared with the most recent CMS data, these enrollment findings indicate a notably larger share ofMedicaid beneficiaries in comprehensive managed care arrangements. CMS data show that, as of June30, 2009, enrollment in MCOs and PCCM programs totaled 31.4 million, or 62.2 percent of all Medicaidenrollees. MCOs accounted for 24.1 million enrollees and PCCM programs accounted for 7.3 million,reflecting the same roughly 75/25 split between MCO and PCCM enrollment as indicated by this survey.The share of Medicaid beneficiaries enrolled in comprehensive managed care was at least 50 percent in42 states, including 13 states in which the share was greater than 75 percent. Table 3 provides state-bystatedata on Medicaid MCO and PCCM enrollment.Table 2: National Medicaid Enrollment in Comprehensive Managed Care:Comparison of KCMU/HMA <strong>Survey</strong> Data and CMS DataKCMU/HMA <strong>Survey</strong> Dataas of October 2010(millions)CMS Enrollment Dataas of June 2009(millions)MCO Enrollment 26.7 24.1PCCM Enrollment 8.8 7.3Total Comprehensive Enrollment(MCO+PCCM)35.5 31.4Share of Total Enrollment 65.9% 62.2%Sources: KCMU/HMA <strong>Survey</strong> of Medicaid Managed Care, September 2011; National Summary ofMedicaid Managed Care Programs and Enrollment, CMS (data as of June 30, 2009).14 00