Managed Medicaid Businesses Expansion

The expansion of Medicaid will bring opportunities for strong enrollment growth to health plans with managed Medicaid businesses. To optimize this membership growth, health plans need to create products with care management strategies that can effectively and efficiently manage this population’s unique healthcare needs.

Our studies show their health and utilization patterns are different from those of existing Medicaid beneficiaries and from those who have employment-based insurance. Health plans must carefully evaluate their plan design and program impacts to best manage costs and care. Plans operating in multiple states will have the further complexity of targeting their strategies to align with the Medicaid expansion decisions.

Anita Nair-Hartman

Vice President, Market Planning and Strategy