Wednesday, 31 January 2018

The Few Winners from Medicaid's Shift to Managed Care

Medicaid, the massive U.S. government health program that covers 75 million people, is shifting from its traditional fee-for-service model to a managed care model. Given the pressures on managed care organizations (MCOs) -- health plans managed by private companies that provide care for 65 percent of Medicaid beneficiaries -- a winner-take-all scenario is likely to develop. To compete in this emerging world, companies will have to develop new capabilities in several areas, including knowledge of customers, risk management, service delivery, and compliance.

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