Medicaid Managed Care

Legal protections are crucial to ensure that Medicaid enrollees access necessary benefits and services from MCOs

As of 2016, more than 81 percent of people enrolled in Medicaid receive health care services through managed care. Risk-based managed care can help states predict Medicaid costs since it provides fixed payments for covered services. Medicaid enrollees may encounter problems accessing needed benefits and services because Managed Care Organizations (MCOs) may have a financial incentive to deny care. If enrollees use fewer services, the MCOs can keep any leftover payment as profit.

National Health Law Program has worked since the mid-1980s to ensure robust consumer protections in managed care, holding MCOs and state agencies accountable for their obligations to Medicaid enrollees.

Managed Care Resources

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Medicaid's 56th Anniversary

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NHeLP has defended Medicaid for over 50 years. This week, we are celebrating the 56th anniversary of Medicaid and recommitting to our efforts to protect and advance health rights for all. Join us in celebration with a donation today! Happy Birthday Medicaid!

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