Trend toward private Medicaid health plans continues in 2015

The trend toward private Medicaid health plans has continued in 2015, with an increase in enrollment by 7.8 million beneficiaries in the last year, according to a new report.

Today, 70 percent of all Medicaid beneficiaries, or 51.3 million Americans, receive benefits from a private Medicaid health plan--an increase from 66 percent last year, according to the report, from from consulting firm PwC. That growth was fueled by an expansion of Medicaid benefits for low-income and disabled people under the Affordable Care Act, as well a continuing shift to managed care by a number of large states, according to the report, which was released at the Medicaid Health Plans of America's (MHPA) annual meeting.

Since full implementation of the ACA in 2014, the number of Medicaid beneficiaries has exploded by 15.3 million people--with an additional 1.7 percent or 6.3 million Americans joining the Medicaid rolls in 2015. "With so many individuals receiving Medicaid coverage, and budgets continuing to be squeezed, states are increasingly turning to private plans to control spend[ing] and provide budget certainty," according to the report.

Currently, 41 states have some form of private managed Medicaid, with Idaho being the latest state to join the list, the report adds. "Even if no other state expands Medicaid (under the ACA), managed care is going to increase its market share because states are moving away from fee-for-service medicine," Jeff Myers, chief executive of MHPA, the trade group and lobby that represents Medicaid plans, told Forbes.

The expansion of privately managed Medicaid has been good news for health insurance companies, with private plans adding beneficiaries. Meanwhile, those enrolled in fee-for-service or public managed plans dropped by 1.4 million in the past year, the report said.

Despit political opposition, none of the 10 Republican governors who have opted to expand Medicaid in their states have reneged on the decision, FierceHealthPayer has reported. In addition, the program has been pushing toward innovation, with many Medicaid directors spending much of their time on payment and delivery system reforms.

To learn more:
- read the report
- read the article in Forbes

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