Medicaid Managed Care
Expert articles and analysis related to medicaid managed care.
AI Summary — Last 30 Days
The Trump administration’s CMS is tightening Medicaid financing oversight, with proposed rules under OBBBA targeting provider taxes and state-directed payments—changes HFMA estimates could reduce Medicaid payments by $220 billion over 10 years—creating major downstream risk for hospitals, safety-net systems, Medicaid MCOs, and VBC entities that rely on supplemental funding to support population health infrastructure. At the same time, HHS has paused $1 billion in Medicaid payments to California and Minnesota over fraud concerns, while work requirements and eligibility-verification complexity are increasing coverage churn risk, especially for medically complex and SSI-adjacent populations. For ACOs, Medicaid managed care plans, and provider-led risk models, the strategic issue is shifting from care-model design alone to financing durability, state partnership strategy, and resilience against enrollment volatility and supplemental-payment retrenchment.
Related Articles
Medicaid managed care: An Explainer
A paper by Mark Shepard and Jacob Wallace (2026) has a great overview of the Medicaid managed care program. The first question one may have is, how does Medicaid managed care differ from other forms o...
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As SUD IMD waiver evaluations and renewals are becoming available, states face a shifting Medicaid and policy and waiver landscape. This brief examines findings from the first available summative eval...
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New Federal Pharmacy Demonstrations: Key Considerations for Medicaid Decision-Makers
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