HJNO Jul/Aug 2026

50 JUL / AUG 2026 I  HEALTHCARE JOURNAL OF NEW ORLEANS MEDICAID COLUMN MEDICAID MANAGED CARE ORGANIZATIONS (MCOs) serve as the primary delivery system for Medicaid, covering roughly 70% of Medicaid enrollees in Louisiana — 30% of the state’s total population. Together with the healthcare providers in their networks, there is great potential to be powerful drivers of public health outcomes. But as Medicaid continues to evolve, so too must the expectations placed on both health plans and the providers who care for their members. In today’s environment, delivering high-quality care, sharing data, and actively collaborating with health plans are no longer optional; they are fun- damental requirements for success. Higher Expectations for Medicaid For decades, Medicaid has expanded ac- cess to care, but access alone is not enough to improve health. Across the country, and particularly in states like Louisiana, health outcomes remain stubbornly poor. Louisi- ana, for example, consistently ranks at or near the bottom nationally in key health indicators. Recognizing that access alone is in- sufficient to improve health outcomes, states are making significant investments to strengthen the provider landscape. In Louisiana, this includes increasing reim- bursement rates for physicians to 85% of the Medicare rate and making substan- tial state-directed payments to hospitals. At this point, the familiar complaint that “Medicaid doesn’t pay enough” is increas- ingly hard to defend. These investments are signals of a stra- tegic shift in Medicaid, carrying with them a clear expectation: measurable improve- ment in quality, outcomes, and systemper- formance. From Participation to Performance Historically, Medicaid managed care has relied on value-based incentives to encourage improved performance. Today, however, quality is no longer an incentive layered on top of the system — it is the pri- mary purpose and driving mission of the system. MEDICAID’S NEXT CHAPTER: Performance, Partnership, & Accountability