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 services …
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 starting between …
Guidance | Medicaid
Managed care technical assistance is available to assist state Medicaid agencies in developing, enhancing, implementing, and evaluating managed care programs.
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 …
Managed Care Authorities | Medicaid
Regardless of the authority, states must comply with the federal regulations that govern managed care delivery systems. These regulations include requirements for a managed care plan to have a quality …
Managed Care in Kentucky This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program …
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 health care …
State Managed Care Quality Strategies | Medicaid
States' Responsibilities for Updating and Posting the Managed Care Quality Strategy Each state Medicaid and CHIP agency contracting with any of the four types of managed care entities - …
Managed Care in Minnesota This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program …
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 Program …