Kaiser Family Foundation Launches Online Tool to Track Medicaid Managed Care

With the share of Medicaid beneficiaries enrolled in managed care past the halfway mark, a new online tool from the Kaiser Family Foundation will help policymakers and researchers track its status in 39 states.

With half the nation’s 67.9 million Medicaid beneficiaries in managed care and that share growing, the Kaiser Family Foundation (KFF) yesterday unveiled an interactive, online tool that lets users evaluate data gathered from the 39 states that enroll clients in managed care.

The Medicaid Managed Care Market Tracker is part of KFF’s State Health Facts data center. A statement from the foundation says it will provide “the latest data on key dimensions of risk-based Medicaid managed care for the 39 states that contract with MCOs—these states are home to more than 90% of all Medicaid beneficiaries.”

Elements on the tracker will include:

  • State-level enrollment and spending figures
  • MCO quality data
  • MCO ownership information, including parent firms
  • Parent firm participation nationwide

KFF’s statement notes that 19 states that account for 45% of Medicaid enrollees publicly report their information, while data from the others will be gathered from multiple secondary sources.

The Kaiser tool comes at a time when states are continuing their march into managed care for Medicaid administration, with extensive use of third-party contractors, despite reports of difficult transitions around the country. Prior to its widely praised launch of its exchange to enroll clients under the Affordable Care Act, Kentucky struggled with a rapid transfer to Medicaid managed care. As is often the case, officials told The American Journal of Managed Care that their hand was forced by a budget crisis.

Since then, Kansas’ experiment with Medicaid managed care has resulted in complaints about slow payments and losses for insurers, while in Ohio, news reports tell of doctors balking at taking new Medicaid patients in managed care, due to problems such as getting diagnostic tests approved.

New Hampshire delayed moving some of its most vulnerable Medicaid clients into managed care indefinitely. And this week in California, advocates braced for the transition of rural, frail elderly Medicaid patients into managed care, after the 2011 transfer of non-rural patients went poorly.

Yet KFF’s earlier survey of Medicaid directors found that most states plan to expand managed care in the program to hold down costs. Thus, the KFF tool will help researchers and policymakers track how well MCOs are performing in individual locations and nationally.

Along with the tracker, KFF this week also released a report on the state of Medicaid managed care by Julia Paradise, associate director of the foundation’s Commission on Medicaid and the Uninsured. Her report contains many state-by-state on MCO spending, penetration by several well-known national insurers into the Medicaid managed care market, and the prospects for expansion in 2015.

For example, while Medicaid managed care exists in 39 states, market penetration varies. In 2013, 5 states—Arizona, New Mexico, Tennessee, Delaware and Hawaii—covered 60% of the beneficiaries; 9 states covered 35% to 59% of their beneficiaries with MCOs, and the remaining 25 states covered less than 35% of beneficiaries through managed care.

According to Paradise’s report, 5 firms have a large geographic presence nationally: UnitedHealth is in 20, WellPoint, 17; Centene, 15; Aetna 11; and Molina, 11.

Paradise will host a webinar on how to use the KFF online tool on December 11, according to the statement.

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