Understanding The Medicaid Behavioral Health Carve-Out Map – Step One In Health Plan Contracting

Today Medicaid managed care is nearly ubiquitous – 38 state Medicaid programs are operating at least one health plan and 69% of Medicaid beneficiaries are enrolled in a comprehensive managed care plan (see The 2016 OPEN MINDS Medicaid Managed Care Update: A State-By-State Analysis). This, coupled with the move to value-based purchasing both at the state level and the individual health plan level, has made negotiating contracts with managed care plans even more important (see State-By-State Analysis Of Medicaid MCO Requirements For Provider Alternative Payment Reimbursement).

However, in those 38 states with managed care, knowing who . . .