November 2025 Classic Edition - Medicaid Managed Care Organizations: Considerations in Calculating Margin in Rate Setting

Classic Replay: Medicaid Managed Care – Considerations in Calculating Margin

In recognition of National Family Caregivers Month, we're re-releasing this classic episode from June 26, 2017. Dale Hall, Managing Director of Research at the Society of Actuaries, is joined by Steve Siegel, SOA Research Actuary, and Sarah Tepema of Health Care Service Corporation. The conversation explores the SOA's report "Medicaid Managed Care Organizations: Considerations in Calculating Margin in Rate Setting."

Listeners will gain insight into how states structure capitation rates for MCOs, how margins are defined and used beyond just profit, and the real-world impacts these margins have on Medicaid programs—especially important for populations relying heavily on caregivers.

For more information on this report visit: https://www.soa.org/resources/research-reports/2017/medicaid-margins/