Medicaid Managed Care: Compensation of Medicaid Directors and Managed Care Organization Executives in Selected States in 2015

In fiscal year 2017, Medicaid is projected to finance the health care coverage for an estimated 74 million beneficiaries with estimated expenditures of $596 billion.1 State Medicaid directors oversee the day-to-day operations of their state Medicaid programs, and are responsible for a wide array of activities including benefit and payment determinations; procurement of services; and processing of claims for fee-for-service (FFS) delivery services and making payments to managed care organizations (MCOs). Executives of MCOs have a variety of responsibilities in delivering services to Medicaid beneficiaries, some of which are similar to those of state Medicaid directors and others that are different. For example, a MCO executive may oversee the enrollment and payment of providers in managed care—similar to what a state Medicaid director might do for the state’s FFS operations. However, MCO executives may also oversee marketing functions, manage operations across multiple states, or address the capital needs of the organization.2 As of July 2014, almost 77 percent of total Medicaid enrollment was in some type of managed care arrangement.3 MCOs can be for-profit or nonprofit, stand-alone plans, or they can be members of a group of insurers or other holding companies.