The Medicaid program, administered jointly by the Federal and state governments, serves 66 million people at a cost of over 400 billion dollars annually, making it the nation’s largest public health insurer. The Affordable Care Act further increases the program’s reach and supports state-level innovation already underway to improve the program’s efficiency and effectiveness and restructure service delivery and payment. States and the federal government are working to maximize the value and efficiency of Medicaid by reforming payment to reward value over volume, integrating effective care coordination across payers, and streamlining key processes like eligibility determinations across coverage programs. Underpinning a state’s ability to implement these reforms is its capacity to manage its Medicaid program effectively and efficiently.
In this report published by the Kaiser Commission on Medicaid and the Uninsured, the authors discuss key responsibilities that the federal government and states hold for managing the Medicaid program and identify the key issues and challenges states face as they transform the way they do business and achieve key national goals.