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The Medicaid Program and Health Plans’ Role in Improving Care for Beneficiaries: What You Need to Know

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Published on Mar 16, 2016

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Medicaid

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Key Takeaways

  • Today, Medicaid is the largest federal health program in the country. Over 72 million individuals are now enrolled in the Medicaid and Children’s Health Insurance Programs (CHIP).
  • Medicaid health plans are fundamental to the operation of the Medicaid program. Now Medicaid health plans are the predominant approach used in state Medicaid programs, enrolling approximately 73 percent of all Medicaid beneficiaries.
  • It is crucial for Medicaid health plans to continue to play a crucial role in the Medicaid program. Medicaid health plan innovations are demonstrating improved outcomes for beneficiaries and have served as the engine for delivery system reform throughout the Medicaid program.

Summary

Congress established the Medicaid program in 1965 to serve as a health care safety net for low-income Americans. Today, Medicaid is the largest federal health program in the country. Over 72 million individuals are now enrolled in the Medicaid and Children’s Health Insurance Programs (CHIP).1 The program has become a crucial component in our health care system. Medicaid beneficiaries are more likely to be in poor health, with many suffering from chronic conditions, as well as managing other related health issues that can adversely affect overall health and well-being, such as inadequate housing and low English proficiency. Medicaid provides coverage meeting the unique needs of low-income individuals including low copayments for preventive benefits, coverage of screening and diagnostic services for children, and home- and community-based services and supports for individuals with disabilities.