Managed Care is a health care delivery system organized to manage cost, utilization, and quality. Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.
Overview of Current Managed Care Programs As of July 2011, over 80 percent of all Medicaid beneficiaries were enrolled in some form of managed care. Pennsylvania began experimenting with various managed care arrangements in the 1970’s, beginning with the introduction of its Voluntary Managed Care Program, a comprehensive risk-based MCO program available to most Medicaid beneficiaries in ...
In 2011, the state further expanded managed care through its Healthy Connections Choices program when it began enrolling additional Medicaid beneficiaries formerly served in the FFS system in either the MCO program or the Medical Homes Network Program on a mandatory basis; however, children in foster care and with certain disabilities, Medicaid ...
In addition to MCO taxes that utilized the loophole, a small number of state taxes on other permissible classes also relied on it. These non-MCO taxes generally shift a smaller share of costs to the federal government than MCO taxes and are less common.
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