Medicaid managed care trends: What health plans should know about potential impacts of policy from the new Trump Administration
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While policymakers have sought to reduce Medicaid program costs for years, significant reforms are gaining momentum under the new Trump Administration.
For many health plans, especially many local and regional plans, Medicaid managed care is a primary source of revenue and key component of a comprehensive government programs product strategy, considering potential member churn between Medicaid, Affordable Care Act (ACA) marketplace, and Dual Special Needs Plans (D-SNPs). Changes to how Medicaid is funded would have a material impact on all aspects of the nation’s healthcare system, most immediately to beneficiaries and providers dependent on Medicaid, as well as on the MCOs that support them.
MCOs should begin taking steps to prepare for potential changes to their Medicaid operating models and growth plans, even if changes made at the federal level do not impact states in the immediate term.
In this executive brief, we discuss themes of potential policies that would impact Medicaid programs, the financial impacts to Medicaid managed care organizations, and five steps for health plans to navigate these changes.