Texas contracts out amount setting to an actuarial consulting company. Texas does not have a minimum amount MLR but in its place calls for Medicaid MCOs share a proportion of gains back again Together with the state. This pool of resources might be utilised to deliver incentive payments for MCOs to further improve good quality of care, inspire payment reform, or minimize inappropriate or preventable solutions (among the other matters).
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Medicaid managed care businesses (MCOs)—non-public industrial insurance policy companies contracted through the point out to administer the Medicaid system—deal with approximately sixty five% of Medicaid beneficiaries and account for fifty two% of whole Medicaid spending nationally.
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