States should re-evaluate Medicaid managed care plans, report says

States will have to consider changes to their Medicaid managed care plans in order to accommodate the bigger, more diverse population expected to apply for Medicaid benefits, according to a new report.

Currently, about 71% of Medicaid recipients access benefits through managed care, and that percentage is expected to grow quickly thanks to the ACA, according to the report, which was released by the Medicaid and CHIP Payment and Access Commission Wednesday. While managed care plans can vary, more states are relying on comprehensive risk-based managed care, with enrollment in these plans growing from 15% of Medicaid enrollees in 1995 to 47% in 2009.
 
Medicaid, as delivered via managed care, typically covers children and parents. But the expansion will cover beneficiaries with more complicated needs, such as individuals who are disabled. For instance, this group might need a wider variety of providers to choose from in a plan, whereas a beneficiary with a less complex health history would not. The mandatory and auto-enrollment processes for disabled individuals versus children and low-income families may need to be different, the report states.

Click here to read the report.