As the Medicaid market landscape continues to expand in the wake of COVID-19, Medicaid managed care organizations (MCOs) focus on reducing overall costs while growing their Medicaid business. HIRC's report, Medicaid MCOs: Market Landscape and Strategic Imperatives, reviews the current market landscape, Medicaid executives' strategic imperatives and objectives, and examines views on market trends that could further affect the segment. The report addresses the following questions:

• What is the current landscape of the Medicaid MCO market and which plans currently account for the majority of market share?
• What are Medicaid MCO plan executives' most important strategic imperatives and which operational objectives are of highest priority?
• What do Medicaid panelists identify as the most notable government-related market trends in 2020? What are the lasting clinical and economic impacts of COVID-19?
• Which therapeutic areas are most often targeted for quality metric adoption?
• Which MCOs are highest in ability to limit access? Which are most willing to partner?

Key Finding: Respondents identify improving overall quality of care, moderating specialty drug spend, and increasing Medicaid member enrollment as the most important strategic imperatives in 2020.

Medicaid MCO Executives Identify State Mandates and Regulations as the Top Government Market Trend in 2020. Medicaid MCO respondents were asked to provide one government-related market trend with the highest potential to change the Medicaid MCO business in the next 1-3 years. Panelists identify state mandates, such as state PDL and UM requirements, as the top government-related market trend, followed by changes to the ACA and the potential shift to a single payer system, and value-based contracting.

The full report includes a complete listing of all Medicaid MCO government-related market trends in 2020.

COVID-19 Trends: Lasting Clinical Impacts. Medicaid MCO key decision-makers were asked what they believe the lasting clinical impact of the COVID-19 pandemic will be on their organization. Respondents identify the lasting impact of telemedicine as the top clinical impact of COVID-19, followed by reduced office visits and lack of routine care.

COVID-19 Trends: Lasting Economic Impacts. Medicaid MCO key decision-makers were asked what they believe the lasting economic impact of the COVID-19 pandemic will be on their organization. Respondents identify the loss of commercial lives and shift to Medicaid as the top economic impact, followed by increased cost due to hospitalizations, testing, drug use, and long-term care.

The full report includes a complete listing of Medicaid MCO perceived lasting clinical and economic impacts of the COVID-19 pandemic.

Research Methodology and Report Availability. In September 2020, HIRC surveyed 36 Medicaid MCO pharmacy and medical directors from national, regional, and BCBS plans. Online surveys and follow-up telephone interviews were used to gather information. The complete report, Medicaid MCOs: Market Landscape and Strategic Imperatives, is available now to HIRC’s Managed Markets subscribers at www.hirc.com.