Medicaid Managed Care: Lots Of Unanswered Questions (Part 1)

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Enrollment of the nation’s 74 million Medicaid recipients in managed care plans continues to increase. By 2016, an estimated 71 percent of Medicaid recipients were receiving their care via private health plans, both investor-owned and nonprofit. The theory behind this shift is that managed care plans can do things that state Medicaid agencies cannot, such as use sophisticated network contracting, information technology, and utilization management systems to squeeze out low-value care and improve the health of beneficiaries.