Medicaid and CHIP Risk-Based Managed Care in 20 States. Experiences Over the Past Decade and Lessons for the Future.. CHIP Plans.

07/01/2012

In the seven states with CHIP risk-based managed care programs that are not fully integrated with Medicaid, there is a somewhat different mix of plans to that of Medicaid (see Figure 7 and Appendix B, Table 5), with more nonprofit public-only plans for CHIP in those states.


Figure 7: Types of Managed Care Organizations Participationg In CHIP
Programs in Seven Study States, 2010

Figure 7: Types of Managed Care Organizations Participationg In CHIP Programs in Seven Study States, 2010

Source: review of state documents.

Note: State-specific details are provided in appendix B, Table 5


Despite this difference, there is substantial overlap in the plans that participate in both Medicaid and CHIP. Of the 189 plans participating in either program in the 20 study states, fully 147 participate in both Medicaid and CHIP with 15 participating only in CHIP and the remaining 27 participating only in Medicaid (see Figure 8). There are only three states without a very substantial overlap in the two programs’ plans (see Appendix B, Tables 4 and 5).


Figure 8: Number of Managed care Organizations with Medicaid
or CHIP Enrollment in study states, 2010

Figure 8: Number of Managed care Organizations with Medicaid or CHIP Enrollment in study states, 2010

Source: Review of state documents

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