Which of the following describes Medicaid services excluded from managed care plans?

In the context of Medicaid services within managed care plans, a "carve-out" refers to specific health services or benefits that are excluded from the managed care contract and instead provided through a different arrangement. This means that while some services may be integrated into the managed care plan, others—such as certain specialty services or high-cost treatments—are retained outside of that plan. Carve-outs allow for specialized management of these services and can lead to more tailored care for patients who require such services.

By utilizing carve-outs, Medicaid programs can address particular healthcare needs that may not be adequately managed by the primary managed care plan. This structure can improve access to necessary services, ensuring that beneficiaries receive appropriate and high-quality care for those specific needs.

In contrast, alternatives such as a carve-in approach would integrate certain services directly into the managed care plan, which may not be suitable for all types of care that require specialized attention. Integrated care implies a more encompassing approach to delivering services where all elements are included under one management system, while participating services suggest involvement in the managed care plan without the specificity of exclusion or inclusion.

Thus, recognizing carve-outs is essential in understanding the complexities of Medicaid managed care and the efforts to optimize healthcare delivery for beneficiaries.