Reining in Medicaid Managed Care

Managed Care Organizations: Medicaid’s Costly Middleman

States subcontract with private insurers to side-step limits on federal funding.

Reining in Medicaid Managed Care

When Medicaid, the U.S. program that purchases health care for the poorest Americans, originally went into effect, states paid directly for health-care services provided to beneficiaries. But in recent decades, states increasingly subcontract procurement to private insurers known as managed care organizations (MCOs). From 1992 to 2022, the proportion of Medicaid beneficiaries enrolled in MCOs […]