Rockville, Md. – Over the past 20 years, more and more eligible persons have received their Medicaid and Children’s Health Insurance Program (CHIP) benefits through private managed care organizations (MCOs), an approach that’s intended to improve costs and quality of care. Between 2010 and 2020, the percentage of Medicaid and CHIP enrollees who were covered by MCOs increased from 47 percent to 72 percent, and now represent over 50 million persons. Additionally, more states are partnering with MCOs to cover elderly and differently abled populations. Among 49 states there are 170 managed care programs, and that number is growing.
To help manage the growth of the Medicaid and CHIP managed care programs, the Centers for Medicare and Medicaid Services (CMS) selected the Abt Team, including Abt Associates and Health Management Associates, to provide strategic support for the execution and oversight of these important programs. Under the $27 million task orders, the Abt Team’s duties include:
- Reviewing managed care contract actions for efficiency.
- Designing and executing comprehensive Medicaid and CHIP managed care monitoring and oversight activities.
- Designing and executing a data-use strategy to organize, standardize, and utilize managed care data from multiple sources to effectively monitor and evaluate performance of Medicaid and CHIP managed care programs.
- Developing tools to help states develop and execute Medicaid and CHIP integrated delivery systems, and in implementing and complying with statutory and regulatory laws.
- Providing technical assistance to CMS, states, and managed care entities on an array of managed care topics to help ensure compliance with regulations.
- Implementing business process improvements to ensure CMS efficiently executes its managed care activities.
“This contract expands our long-term relationship with CMS and brings together our deep knowledge of Medicaid managed care operations at the state and federal levels, as well as our digital and project management capabilities,” said Susan Longley, Abt vice president of heath policy. “We know every dollar in healthcare matters to beneficiaries, providers, and insurers, and we’re proud to partner with federal and state agencies on such important work.”
About Abt Associates
Abt Associates is a global consulting and research firm that combines data and bold thinking to improve the quality of people's lives. We partner with clients and communities to advance equity and innovation—from creating scalable digital solutions and combatting infectious disease, to mitigating climate change and evaluating programs for measurable social impact. https://www.abtassociates.com