On June 15, the Medicaid and CHIP Payment and Access Commission (MACPAC) released a report examining the use of managed care in Medicaid, finding that 71 percent of Medicaid beneficiaries are enrolled in managed care plans.  However, the authors also determined that managed care plans account for only 21 percent of Medicaid spending, primarily because beneficiaries with the highest medical costs are not enrolled in managed care.  In addition, the report found that the percentage of Medicaid beneficiaries enrolled in the most prevalent type of managed care plans, known as comprehensive risk-based managed care plans, rose from 15 to 47 percent between 1995 and 2009.  The authors project that, as health reform is implemented, more high-cost beneficiaries will be enrolled in managed care plans to reduce costs through improved care coordination. 

From the report:

Medicaid is a source of health care coverage for 67 million low-income people, over a fifth of the U.S. population. Medicaid finances health care and related services for more than 30 million low-income children, more than 10 million persons with disabilities, and 6 million low-income seniors with Medicare. Approximately 49 million Medicaid enrollees receive care through some form of Medicaid managed care. Understanding the different Medicaid managed care arrangements and the interactions between states, plans, providers, enrollees, and the federal government is important to understanding how the Medicaid program—which accounts for approximately 15 percent of U.S. health care spending—fits into the larger health care delivery system.

Full Report: The Evolution of Managed Care in Medicaid (PDF | 4.99 MB)

Medicaid and CHIP Payment and Access Commission. (2011). The evolution of managed care in Medicaid