Texas Medicaid MCO Financial Performance Shows Membership Declines and Margin Pressure Through Redetermination Period

Milliman's quarterly financial analysis of Texas Medicaid managed care plans through Q4 SFY 2025 documents how the end of continuous coverage protections affected MCO enrollment, net income, and medical loss ratios across STAR, STAR Kids, STAR+PLUS, CHIP, and dual-eligible programs. The report examines financial metrics including directed payment pass-through expenses, administrative costs, and experience rebate impacts as plans navigated large-scale eligibility redeterminations. State Medicaid directors and MCO finance teams can use these program-specific benchmarks to assess operational performance during the unwinding period and inform rate-setting discussions.

Managed Care · Finance · LTSS · Behavioral Health · CHIP · Dental · Maternal

This is outside commentary from Milliman, not part of Medicaid Monitor's independently scored news coverage.

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