Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary — Last 24 Hours
Elevance is moving to exit its D.C. Medicaid managed care business and is evaluating additional market withdrawals as Medicaid cost pressure remains elevated, signaling tighter MCO participation and potential network/care-management disruption for state Medicaid VBC arrangements and provider risk contracts (Healthcare Dive). At the same time, implementation concerns around new Medicaid work rules are intensifying, with advocates warning of state administrative burden and coverage losses—raising near-term churn risk for managed care plans, ACO-like Medicaid models, and population health programs that depend on stable enrollment. KFF’s updated dual-eligible analyses underscore why Medicare-Medicaid integration remains strategically central: roughly 12 million dual-eligible individuals account for disproportionate spending, making D-SNP alignment, LTSS management, and cross-payer care coordination critical targets for VBC strategy (KFF).
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Oregon Medicaid Launches Nutrition Benefits For Members With Complex Health Conditions  open minds
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Approximately 12 million people are enrolled in both Medicare and Medicaid, referred to as dual-eligible individuals. This brief examines the demographic, socioeconomic, and health characteristics of ...
Five Key Facts About Spending and Enrollment for People with Medicare and Medicaid (Dual-Eligible Individuals)
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Elevance shuts down D.C. Medicaid business, eyes additional exits after passable Q2
Elevance will leave D.C. this summer and is considering other markets to depart, executives said. The company outperformed Wall Street expectations in the second quarter — but not by much, and its sto...
Advocates Say New Medicaid Work Rules Will Burden States, Jeopardize Coverage
Advocates Say New Medicaid Work Rules Will Burden States, Jeopardize Coverage  HCI Innovation Group
Missouri Rebids Statewide Medicaid Managed Care Contracts For General & Specialty Plans - open minds
Missouri Rebids Statewide Medicaid Managed Care Contracts For General & Specialty Plans  open minds
Community Voices from North Carolina’s Healthy Opportunities Pilots Program: Implications for Designing and Evaluating Programs to Address Upstream Drivers of Health | Milbank Memorial Fund
From newsletter: Community Voices from North Carolina’s Healthy Opportunities Pilots Program Participants’ stories show the value of meeting people’s holistic needs through Medicaid ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ...
upstream drivers of health
From newsletter: Community Voices from North Carolina’s Healthy Opportunities Pilots Program Participants’ stories show the value of meeting people’s holistic needs through Medicaid ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ...
STAT+: Elevance plots a Medicaid retreat as costs remain high
Elevance Health, the country’s second-biggest health insurer, said it plans to further shrink its Medicaid portfolio in the coming year, just as states roll out work requirements.