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Managed Care

The growth of managed care over the last several years has changed fundamental aspects of the Medicare and Medicaid programs. This significant shift transformed how the government pays for and covers health care for approximately 100 million enrollees.

During 2024, 54 percent of people in Medicare received their care through a Medicare Advantage plan.   During 2024, the government spent an estimated $462 billion.  Medicaid Managed Care has experience similar growth.  Currently, 81% of Medicaid beneficia

Strategic Plan

Download the Managed Care Strategic Plan

The OIG has designated oversight of managed care as a priority area. OIG has developed a strategy to align its audits, evaluations, investigations, and enforcement of managed care. The HHS-OIG Strategic Plan for Oversight of Managed Care for Medicare and Medicaid has three goals:

  1. Promote access to care for people enrolled in managed care
  2. Provide comprehensive financial oversight
  3. Promote data accuracy and encourage data-driven decisions

OIG developed the managed care life cycle to guide oversight and enforcement work. The life cycle of managed care is fourfold: plan establishment and contracting, enrollment, payment, and the provision of services. Each stage of this life cycle raises different risks and vulnerabilities.

Life cycle diagram. OIG Oversight: Plans CMS/States/Providers/Vendors: 1. Plan Establishment & Contracting, 2. Enrollment, 3. Payment, and 4. Service to People

Resources

Audits

The Office of Audit Services conducts independent audits of HHS programs and/or HHS grantees and contractors. These audits examine the performance of HHS programs and/or grantees in carrying out their responsibilities and provide independent assessments of HHS programs and operations. These audits help reduce waste, abuse, and mismanagement and promote economy and efficiency throughout HHS. The most recent managed care related audits are listed below.

Evaluations and Inspections

The Office of Evaluation and Inspections conducts national evaluations of HHS programs from a broad, issue-based perspective. The evaluations incorporate practical recommendations and focus on preventing fraud, waste or abuse and encourage efficiency and effectiveness in HHS programs. The most recent managed care related evaluations are listed below.

Work Plan Items

View active work plan items related to managed care

Criminal and Civil

OIG often works with government partners to investigate allegations of fraud in managed care. Some examples of case resolutions involving Medicare and/or Medicaid managed care fraud allegations:

OIG annually publishes the top unimplemented recommendations that, in our agency's view, would most positively affect HHS programs in terms of cost savings, program effectiveness and efficiency, and public health and safety if implemented. Recommendations regarding managed care that were unimplemented as of December 2023 appear below.

View all top unimplemented recommendations.

OIG annually identifies top management and performance challenges HHS faces as it strives to fulfill its mission. View challenges regarding managed care below.

OIG regularly testifies before Congress in oversight hearings. Below are links for hearings related to managed care.

Last updated January 22, 2025