Managed Care Seen as Future of Medicaid

Roughly 85% of Medicaid enrollees will be in managed care organizations by 2020, a health consultant and former state Medicaid director predicted here.

That's in contrast to today, when currently nearly half of Medicaid enrollees are in managed care and roughly 78% of reimbursements come from fee-for-service, said Vern Smith, PhD, managing principal at Health Management Associates in Naples, Fla.

"There is tremendous upside potential for serving this population going forward," Smith told the audience in his keynote address at the annual conference of the Medicaid Health Plans of America (MHPA), a national trade group of Medicaid health plans.

As Medicaid becomes a larger chunk of state budgets and enrollment grows under Medicaid expansion of the Affordable Care Act, states are turning to managed care to better handle costs, especially for certain populations, said Smith, a former Medicaid director in Michigan.

Michael Rashid, MHPA board chair, too noted the increase in Medicaid managed care during his address. "Traditional fee-for-service Medicaid -- to be honest -- has become a thing of the past," Rashid said.

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Source: MedPage Today