The Affordable Care Act encourages states to implement a major expansion in Medicaid eligibility. Many of the new beneficiaries will be enrolled in Medicaid managed care. At the same time, states increasingly are looking to managed care to cover more high-cost populations and services. In addition to potential savings, states value the budget predictability that comes from managed care. Consumer advocates and providers, however, have expressed concerns about network adequacy, access to care and quality of care, especially as states move more high-cost populations to managed care.
This synthesis examines the evidence on whether states have saved money using managed care for their Medicaid populations and whether managed care beneficiaries have better access to services or receive higher quality care than their fee-for-service counterparts.