Reform

Medicaid Managed Care Program Database

The Medicaid Managed Care Program Database offers a granular view of all capitated managed care programs (including MCOs, HIOs, PIHPs, PAHPs, and PACE programs) across the country, broken down by state and program, as of January 2015. This data includes program specific details such as participating MCOs, current program enrollment, services included and excluded (with detail on special needs services such as behavioral health, long-term supports and services, and intellectual and developmental disabilities services), eligibility, geography, mandatory vs. voluntary enrollment, quality incentives, waiver entities, and more.

Specifically, the database includes:

  • Data across all 120 managed care programs and ~500 participating managed care organizations in the U.S.
  • Managed Care Programs broken down by MCO, MCO parent company, and parent company type showing the MCO’s date of entry, services covered and number of lives covered
  • Information on complete state programs including total managed care spend, total enrollment, use of quality incentives, and trends associated with managed care
  • Insight on types of managed care programs, including MCO, PACE, PIHP, PAHP, HIO, and non-emergency transportation and dental programs