Managed Care | Medicaid
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 …
Managed Care Entities | Medicaid
Federal Managed Care regulations at 42 CFR 438 recognize four types of managed care entities:Managed Care Organizations (MCOs)Comprehensive benefit packagePayment is risk …
Introduction The Centers for Medicare & Medicaid Services (CMS) is releasing the 2025-2026 Medicaid Managed Care Rate Development Guide for use in setting rates for rating periods …
Enrollment Report | Medicaid
The Medicaid Managed Care Enrollment Report provides plan-specific enrollment statistics on Medicaid managed care programs. The managed care enrollment report includes statistics, in …
Quality of Care External Quality Review | Medicaid
An External Quality Review (EQR) is the analysis and evaluation by an external quality review organization (EQRO) of aggregated information on quality, timeliness, and access to the …
A. Plan transitions in Medicaid managed care Over the past decade, states have increasingly used managed care delivery systems to provide Medicaid services to enrollees. Most …
Rate Review and Rate Guides | Medicaid
2026-2027 Medicaid Managed Care Rate Development Guide In February 2026, CMS released the 2026-2027 Medicaid Managed Care Rate Development Guide for states to use when …
This guide is designed specifically for review of managed care plan (MCP) contracts serving the Medicaid population. The State Guide to CMS Criteria for Children’s Health Insurance …
Guidance | Medicaid
Managed care technical assistance is available to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating managed care programs.
Managed Care in Texas This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as …