Peyton List Leak Fresh 2025 File Collection #647

This page contains information for medicaid providers who wish to provide services for apple health (medicaid) managed care clients. 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. Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver medicaid services to enrollees. The choices that medicaid agencies make around delivery systems, including choices around the use of capitated managed care, have real impacts on how medicaid members experience care As medicaid managed care continues to evolve, it will be important to understand its impact on health care quality, access, and cost. In contrast to the ffs model where the state pays providers directly, medicaid managed care (mmc) involves the state contracting with private insurance companies, known as managed care organizations (mcos), to deliver medicaid health benefits and services to enrolled beneficiaries. As directed in 2014 by house bill 2572 and senate bill 6312, the health care authority and the department of social and health services implemented a phased approach to integrating physical and behavioral health services in managed care. Medicaid state plan amendments access to care program integrity cost sharing indian health & medicaid outreach tools quality of care enrollment strategies home & community based services program information section 1115 demonstrations managed care eligibility financial management data & systems benefits prescription drugs long term services. This brief introduces medicaid managed care, including how it works, how it has changed over time, evidence on its effectiveness, and more recent policy trends in what and who is covered by medicaid managed care.