Increased enrollment, increased costs
For states, private managed care organizations (MCOs) are an important partner in managing the growing Medicaid population while reducing the financial risk of management. Not every MCO is capable. Many are hard pressed to provide the full scope of services necessary to the complexity of the tasks, especially in states where funding is inadequate.
The evidence suggests private Medicaid MCOs have been successful in improving health and containing Medicaid costs. But there is another path for state. The implementation of managed care practices into existing state programs is an option. When deciding which path to take, or selecting the best private Medicaid MCO as a partner, there are several insights to consider.
Navigant provides a guide to navigating the complexities of Medicaid MCO strategies and how to successfully lower total costs while maintain quality.