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AHIP Report Analyzes Medicaid Managed Care Plans

July 2020

As enrollment in Medicaid continues to skyrocket, keeping costs low for both the health plans and consumer is of the utmost importance. AHIP’s latest report shows that Medicaid managed care programs provide value and quality and that more states are relying on these programs to provide care management and administrative services.

“Medicaid and its safety net are more important than ever, as tens of millions of hardworking Americans have lost their jobs because of the COVID-19 crisis,” said Matt Eyles, AHIP president and CEO.

The AHIP report explains that the use of capitation payment systems by Medicaid managed care programs is a cost-effective method to deliver high quality care to enrollees. The use of capitated payments in managed care plans has exceeded the usage of fee-for-service payments since 2017.

Between 2010 and 2018, the report from AHIP shows that enrollment in Medicaid managed care programs increased from 26 million to 56 million. Managed care plans were also found to cover 75% of Medicaid enrollees, an increase from 50% in 2010.

This report is the latest in AHIP’s analyses series of managed care programs in collaboration with the Menges Group, an analysis consulting firm. The first two reports’ most significant findings were that Medicaid managed care programs lower drug costs and improve quality of care.

“The findings make clear that Medicaid managed care plans deliver real savings for states and are effective and accountable stewards of taxpayer dollars,” said AHIP in the report. “When the public and private sectors work together, Americans get the quality and value that they expect and deserve.” —Edan Stanley

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