Managed care

Managed care is a model where a health plan (the managed care organization, or MCO) contracts with the state to provide care to Medicaid beneficiaries in exchange for a fixed monthly payment per enrollee. Roughly 70 percent of US Medicaid beneficiaries are enrolled in MCOs. Major MCOs serving Black patients include Centene/Ambetter, Molina, CareSource, Aetna Better Health, and UnitedHealthcare Community Plan.

Each state's MCO contract includes requirements for member engagement, culturally and linguistically appropriate communication (under Section 1557 and 42 CFR 438), and quality metrics (HEDIS).