Winning in the Medicaid and "Duals" markets: Navigating uncertainty and planning for successful growth

Despite the Supreme Court’s recent decision to allow individual states to opt out of the Medicaid expansion provision of the Affordable Care Act, Medicaid rolls will soon expand by millions of people. Indeed, this decision is just one element of the changing Medicaid landscape. Many states will continue to shift their current Medicaid and “Duals” populations—those who qualify for both Medicare and Medicaid—to managed care organizations (MCOs), creating enormous opportunities and challenges. For MCOs that decide to take the plunge, we propose a multistep approach.