Health Journalism Glossary

Comprehensive risk-based plans

  • Insurance

Comprehensive risk-based plans or managed care organizations (MCOs) are the most common type of Medicaid managed care arrangement. States using this arrangement will pay a qualified health plan a fixed per member per month (PMPM) payment to provide a defined set of health services to plan enrollees through a network of participating providers. If expenditures exceed total income, the health plan is responsible for absorbing the losses.

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