A Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs

October 20, 2015

This primer, prepared by Ellen Breslin of Health Management Associates, includes an explanation of how state Medicaid programs generally pay their MCOs, the overall process for setting Medicaid managed care capitation rates and the various tools that states use to mitigate the risks that MCOs face when they assume financial responsibility for Medicaid members.