Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports

(Authors: Jada Raphael and Elizabeth Hinton for The Kaiser Family Foundation Published: Feb 18, 2026)

Comprehensive, capitated managed care is the dominant Medicaid delivery system, accounting for about 78% of beneficiaries (over 66 million individuals as of July 2024) and 50% of total Medicaid spending (over $458 billion in FY 2024). States were contracting with over 280 individual Medicaid managed care organizations (MCOs) (as of July 2022), which represent a mix of private for-profit, private non-profit, and government plans. Medicaid Managed care contracts are among the largest and most complex state contracts, frequently exceeding billions of dollars a year. While the majority of states contract with managed care plans, states decide which populations and services to include in managed care arrangements, leading to considerable variation across states. States have been largely responsible for monitoring and overseeing managed care plans, while federal rules have evolved over time. Historically, publicly available managed care performance data has been limited and inconsistently available across states, limiting transparency and accountability of individual plans. Continue reading here…

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