Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary — Last 30 Days
Medicaid managed care is entering a sharper margin-and-accountability cycle: CBO’s post-2025 reconciliation projections point to materially lower federal Medicaid spending and enrollment over the decade, while plans are already reassessing market participation, with Elevance exiting D.C. Medicaid and evaluating additional withdrawals as rate adequacy and acuity pressures intensify. At the same time, CMS under the Trump administration is pushing ahead with the ACCESS behavioral health model, but provider and payer scrutiny centers on whether Medicaid payment rates, workforce constraints, and managed care incentives can support the model’s access and integration goals without worsening financial strain. For VBC stakeholders, the strategic issue is no longer just model participation; it is whether Medicaid ACOs, FQHCs, behavioral health providers, and MCOs can align risk, rates, and care-management infrastructure in a tighter fiscal environment. KFF Medicaid projections | ACCESS model scrutiny
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