Payer Implications of the Medicaid Revolution

Summary

The Medicaid managed care market is exploding. Revenue is expected to more than triple from approximately $90 billion to $290 billion between 2010 and 2017. The sources of growth from Medicaid managed care expansion are the result of three primary drivers:

1. Massive increase in managed care penetration
2. Rapid increase in the number of people eligible for Medicaid
3. Shift in the populations served by Medicaid

To survive and thrive in this new world order, payers must be aggressive in order to meet the shift in state program requirements. In this Executive Insights, we draw on our experience to detail six points that Medicaid payers should focus on in order to win RFPs and maximize profit potential in this growing Medicaid managed care environment.