Our Work

"Happy to become a new member of @MHCCMD Payment Model Work Group" Read more on her announcement here.

Insurance exists to protect enrollees against their financial exposure to catastrophically high-cost low-probability events. Indeed, health insurance began as sickness funds, where workers made weekly contributions to a fund that would temporarily provide a reduced wage to those too ill to work.

As of 2020, 70% of Medicaid beneficiaries (57 million) were insured through Medicaid managed care (MMC), in which a private insurer covers a beneficiary’s medical care in exchange for fixed payments from state Medicaid agencies.1 A key role of MMC insurers is to negotiate prices with hospitals. MMC prices have important implications for government health expenditures and access to care for Medicaid beneficiaries. However, little is known about MMC prices.2 We used hospitals’ self-disclosed pricing information to characterize MMC hospital prices.