As the federal government and states seek to get the best value from Medicaid managed care, many officials and researchers have identified concerning trends in plan competition and consolidation that, in many markets, may be having negative effects on costs, quality, and access. But states have strategies available to increase competition among Medicaid managed care plans and drive performance improvements in consolidated markets.

This article, published in Health Affairs, explores Medicaid managed care market consolidation trends, drivers of consolidation, advantages and disadvantages of consolidation, and state strategies to increase Medicaid managed care competition.