Managed Care Enrollment By Program And Population (Duals)

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts.

1. Because Medicaid beneficiaries may be enrolled concurrently in more than one type of managed care program (e.g., a Comprehensive MCO and a BHO), users should not sum enrollment across all program types, since the total would count individuals more than once and, in some states, exceed the actual number of Medicaid enrollees.
2. Comprehensive MCOs cover acute, primary, and specialty medical care services; they may also cover behavioral health, long-term services and supports, and other benefits in some states. Limited benefit managed care programs, including MLTSS only, BHO, Dental, Transportation, and Other cover a narrower set of services.
3. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees.
4. The “Total dually eligible individuals” column represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including enrollees receiving full Medicaid benefits or Medicaid cost sharing.

"--" indicates states that do not operate programs of a given type. 0 signifies that a state operated a program of this type in 2014, but it ended before July 1, 2014, or began after that date.
Organization: U.S. Department of Health & Human Services
Last updated: 2025-02-03T21:52:27.652321
Tags: bho, managed-care-enrollment, mco, medicaid, medicare, mltss, pace, pahp, pccm, pihp