Medicaid Health Plans

Medicaid health plans are playing a growing role in the Medicaid program. More than 24 million low-income individuals throughout the country-- representing nearly 50 percent of total Medicaid enrollment-- rely on Medicaid health plans. Medicaid health plans are at the forefront of implementing systems and programs that not only provide better care coordination for beneficiaries, but also help states control escalating program costs and achieve a high value for their health care dollars.

Medicaid health plans are helping states to modernize their delivery systems for vulnerable populations. For example, prior to enrolling in Medicaid health plans, many beneficiaries lacked primary care providers and, instead, relied on costly emergency rooms as their access point for services. Health plans are providing beneficiaries with continuity – and lower costs – through a dedicated provider that can coordinate care. In addition, beneficiaries often have needs that go beyond medical care that include behavioral and social welfare challenges. Medicaid health plans help facilitate patients’ contact with local, community-based services that can address broader needs. Medicaid health plans are also working with expectant mothers to provide prenatal care and counseling to help them transition to caring for newborns – programs that may far exceed anything available under Medicaid fee-for-service.

By bringing a coordinated and holistic care approach to Medicaid, health plans are improving the health and well-being of millions of low-income individuals and families and helping states to maximize scarce resources.

Latest Documents

AHIP Medicaid Chartpack - [PDF]

Product Policy | 07/10/2012

Capitol Hill Briefing on Access and Quality in Medicaid Managed Care

AHIP hosted a Capitol Hill briefing on how Medicaid health plans improve access and quality of care for beneficiaries while providing cost savings to states. The briefing featured presentations from four Medicaid health plan executives.

AHIP Coverage Blog Posts | 05/11/2011

Medicaid Health Plan Enrollment and Participation Trends, May 2011

This report by America’s Health Insurance Plans (AHIP) analyzes enrollment and participation trends in Medicaid managed care plans. Of the 50.5 million Medicaid beneficiaries nationwide, 23.9 million were enrolled in a Medicaid health plan as of June 30, 2009, an increase of 2.4 million since 2008.

Reports/Fact Sheets/Briefs/Talking Points | Federal | 05/09/2011

USA Today: States turn to private insurance companies for managed care

Kaiser Health News/USA Today examine how states are turning to Medicaid managed care plans to provide care for long-term care patients.

Articles | 02/21/2011

Final AHIP Study -Medicaid Managed Care Cost Savings - [PDF]

Medicaid Managed Care Cost Savings – A Synthesis of 24 Studies Prepared for: Americas Health Insurance Plans July 2004 Updated March 2009 Table of Contents EXECUTIVE SUMMARY .......................................................................................................................... 1 I. INTRODUCTION AND C

Reports/Fact Sheets/Briefs/Talking Points | 05/20/2009

Medicaid Health Plans: Adding Value for Beneficiaries and States - [PDF]

This synthesis of research by America’s Health Insurance Plans (AHIP) demonstrates that Medicaid health plans provide high quality accessible care to beneficiaries and value to states.

Reports/Fact Sheets/Briefs/Talking Points | 05/20/2009

Innovations in Medicaid Managed Care

Health insurance plans are implementing a multitude of creative programs to improve quality and efficiency in Medicaid.

Research | Center for Policy and Research | 03/01/2005

AHIP Report: Medicaid Managed Care Cost Savings - A Synthesis of Fourteen Studies - [PDF]

According to the Lewin Group's review of 14 studies, Medicaid managed care has saved states up to 19% compared with fee-for-service Medicaid.

Research | Center for Policy and Research | 06/01/2004

Amerigroup: Coordinated Case Management

AHIP member company produced video - Amerigroup: Coordinated Case Management

Multimedia Library

Amerigroup: Dedicated Doctors and Nurses

AHIP member company produced video - Amerigroup: Dedicated Doctors and Nurses 

Multimedia Library

EmblemHealth: Finding Creative Ways for a Patient to Afford Treatment

 

Multimedia Library | Center for Policy and Research

EmblemHealth: Overcoming Alcoholism and Addressing Unmet Medical Needs

 

Multimedia Library | Center for Policy and Research

EmblemHealth: Reaching Out to Patients with Complex Conditions

 

Multimedia Library | Center for Policy and Research

Molina: Shots for Shorties and Check Up or Check Out

AHIP member company produced video - Molina: Shorts for Shorties and Check Up or Check Out 

Multimedia Library

SCAN Health Plan: A Better Way to Care

AHIP member company produced video - SCAN Health Plan: A Better Way to Care 

Multimedia Library