Medicaid managed care trends: What payers should know about state priorities and the competitive procurement landscape
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Medicaid managed care has remained a highly competitive space in the last 2–3 years, with at least 18 procurements released across 15 states in 2023 and 2024 alone. Procurements are a critical tool for state agencies as they seek to drive program priorities, address emerging challenges, and innovate across the Medicaid program.
States releasing these solicitations have offered managed care organizations (MCOs) the opportunity to manage more than 16 million members, representing more than $100 billion in annual contract value. Nationals and smaller payers alike have established a highly competitive environment in which state agencies are willing to consider new market entrants offering innovative strategies. In this environment, incumbents need a proactive approach just to retain their market share.
Payers should assess readiness and prepare in their target markets as policies evolve. Incumbents should begin preparing at least 12 months before a procurement release, while new market entrants need at least 24 months.
In this executive brief, we highlight key procurement and award trends, share examples of innovative plans in the market, and identify steps for proactive success.