Medicaid risk-based managed care: Analysis of financial results for 2015

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By Christopher T. Pettit, Jeremy D. Palmer | 06 June 2016
Since the inception of the Patient Protection and Affordable Care Act (ACA) in 2010, and subsequent Medicaid expansion efforts in several states, the number of Medicaid beneficiaries as well as the number of managed care organizations (MCOs) operating in the Medicaid line of business has increased substantially. This report summarizes the calendar year 2015 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners (NAIC) annual statement. The primary purpose of this report is to provide reference and benchmarking information for certain key financial metrics used in the day-to-day analysis of Medicaid MCO financial performance. This report also explores the differences among various types of MCOs using available segmentation attributes defined from the reported financial statements.