Managed care models generated $7B in Medicaid savings in 2016, study finds

Morgan Haefner -

Capitation spending reflected 48.9 percent of national Medicaid expenditures in 2016 and is projected to become the dominant Medicaid expenditure in the future, according to a recent Association for Community Affiliated Plans report.

On behalf of ACAP, Arlington, Va.-based healthcare consulting firm The Menges Group estimated Medicaid savings under a capitated coordinated care model. The firm predicts Medicaid managed care organizations fueled $7.1 billion in national Medicaid savings in 2016. This assumes Medicaid MCO provider unit prices are on par in the aggregate to Medicaid fee-for-service levels, the report states.

The estimated savings accounts for a 2.6 percent of savings on all funds paid through capitation. The Menges Group estimates the national savings from MCOs will total $94.4 billion throughout 2017 to 2026.

If all fee-for-service expenditures transitioned to capitated spending in 2017, an additional $63.2 billion in savings would be added during the 10-year period, the study states.

For the full report, click here

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