Medicaid Managed Care Oversight Toolkit

Bailit Health

Medicaid managed care contracts are among the largest state contracts from a financial perspective. In addition, these contracts are complex and lengthy, requiring state Medicaid agencies to have expertise, processes, and data to interpret, implement, and assess plan performance to ensure enrollee access to necessary covered services. This toolkit is designed to assist state Medicaid agencies in maximizing the value states obtain from contracted managed care entities, on behalf of enrollees and taxpayers.

This toolkit takes a broad approach to contract management and suggests ways state agencies can develop and employ effective vendor management approaches to better achieve their vision and goals for Medicaid managed care programs to improve enrollee care and outcomes.

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