<unk><unk>  and additional services in the United States through an arrangement between a state<unk>  agency and<unk>  care organizations (MCOs) that accept a set payment – "capitation" – for these services. As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. There are two main forms of<unk> , "risk-based MCOs" and "primary care case<unk> ent (PCCM)."<unk>  care delivery systems grew rapidly in the<unk>  program during the 1990s. In 1991, 2.7 million beneficiaries were enrolled in some form of<unk>  care. Currently,<unk>  care is the most common health care delivery system in<unk> . In 2007, nearly two-thirds of all<unk>  beneficiaries are enrolled in some form of<unk>  care – mostly, traditional health maintenance organizations (HMO) and primary care case<unk> ent (PCCM) arrangements. This amounted to 29 million beneficiaries, of which 19 million individuals were covered by fully capitated arrangements and 5.8 million were enrolled in Primary Care Case<unk> ent. During this time, states increasingly turned to health plans already serving the public coverage programs such as<unk>  and SCHIP to operationalize expansions of coverage to uninsured populations. States used health plans as a platform for expansions and reforms because of their track record of controlling costs in public coverage programs while improving the quality of and access to care. A variety of different types of health plans serve<unk>  programs, including for-profit and not-for-profit,<unk> -focused and commercial, independent and owned by health care providers such as community health centers. In 2007, 350 health plans offered<unk>  coverage. Of those, 147 were<unk> -focused health plans that specialize in serving the unique needs of<unk>  and other public program beneficiaries. Over 11 million are enrolled in<unk>  focused health plans . All states except Alaska, and Wyoming have all, or a portion of, their<unk>  population enrolled in an MCO. States can make<unk>  care enrollment voluntary, or seek a waiver from CMS to require certain populations to enroll in an MCO. If states provide a choice of at least two plans, they can mandate enrollment in<unk>  care. Healthy children and families make up the majority of<unk>  enrollees, but an increasing number of states are expanding<unk>  care to previously excluded groups, such as people with disabilities, pregnant women, and children in foster care. In 2003, Hudson Health Plan implemented a patient-specific pay for performance (P4P) model to increase immunization rates and diabetes care for<unk>  recipients.
Medicaid managed care
Managed care
Prospective payment system
Bundled payment
Two-tier healthcare
Free-market healthcare
Terminal illness insurance
Single-payer healthcare