• Corpus ID: 5952086

Medicaid managed care : Costs , access , and quality of care

  title={Medicaid managed care : Costs , access , and quality of care},
  author={Michael S. Sparer}

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The Expanding Role of Managed Care in the Medicaid Program
  • Kyle J. Caswell, S. Long
  • Medicine, Political Science
    Inquiry : a journal of medical care organization, provision and financing
  • 2015
Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures, whereas for disabled adults, there is no association between penetration and health care outcomes.
Health Service Utilization and State Costs Among Adults Aging With Early-Acquired Physical Disabilities in Medicaid Managed Care
MMC could reduce the hospital service use of and state spending on enrollees with early-acquired physical disabilities and this impact may vary depending on the enrollees’ age.
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Comorbidity can be used to identify MMC beneficiaries most likely to have high costs, and was a key correlate of total costs.
How Phantom Networks, Provider Qualities, and Poverty Sway Medicaid Dental Care Access: A Geospatial Analysis of Manhattan
A novel evaluation of the spatial association between poverty, dental care access, and phantom networks suggests that Medicaid dental providers wish to be located in wealthier census tracts that are in proximity to impoverished areas for maximum profitability.
Framing the front door: co-creating a home health care assessment of service need for children with disabilities
This paper details the co-creation of a home health assessment tool for children with disabilities in the context of state-level systems change from traditional Medicaid to Medicaid managed care and how a community based, sequential, mixed methods design led to a comprehensive, person-centered, and holistic tool.
Health Care Cost Drivers and Options for Control
It is found that unit prices and technology remain the most important cost drivers of this recent growth, particularly in the privately insured market, where premiums have risen considerably in the last decade.
Pediatric outpatient utilization by differing Medicaid payment models in the United States
The majority of children in this US Medicaid population had capitated plans associated with higher utilization of acute care, but increased proportion of lower-cost sites, such as PCP-acute visits and UC.
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We explore the linkages between government ideology in U.S. states and geographic variation in Medicaid program design and operations. Medicaid eligibility criteria tend to be more generous in
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The completeness of medical encounters capture among Medicaid enrollees in comprehensive managed care (CMC) has been shown to vary across states and years. CMC penetration has grown, and CMC
Supporting Physical–Behavioral Health Integration Using Medicaid Managed Care Organizations
Key findings of two states that sought to integrate physical and behavioral health services by delivering them through one Medicaid managed care contract are described, finding promising practices include leveraging data accumulated about beneficiaries to support providers and enhanced case management.


Medicaid managed care and infant health.
The impact of Medicaid managed care on hospitalizations for ambulatory care sensitive conditions.
The 33 percent lower rate of hospitalizations for ambulatory care sensitive conditions found in mandatory managed care compared with fee-for-service suggests that Medicaid managed care is associated with a large reduction in hospital utilization, which likely reflects health benefits.
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This book is published monthly by Project HOPE at 7500 Old Georgetown Road, Suite 600, Health Affairs with permission from the Publisher.
Implementation of mandatory Medicaid managed care in Missouri: impacts for pregnant women.
Although women experienced significant improvements statewide in prenatal care under Medicaid, improvements were smaller for managed care counties, which may have a positive impact on smoking cessation, but other policy changes may be needed to improve birth outcomes.
A cost analysis of the Iowa Medicaid primary care case management program.
Use of a Medicaid PCCM program was associated with substantial aggregate cost savings over an 8-year period, and this effect became stronger over time.
Effects of Tennessee Medicaid Managed Care on Obstetrical Care and Birth Outcomes
A comparative study was conducted in two neighboring states, Tennessee and North Carolina, to determine whether Medicaid managed care (implemented in Tennessee as TennCare) affected prenatal care,
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OBJECTIVE To evaluate the effects of managed care on Medicaid beneficiaries' satisfaction with, access to, and use of medical care during early implementation of an enrollment initiative. DESIGN
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This study failed to find that increases in Medicaid managed care lead to increased primary care physician participation in Medicaid during the period 1996–2001.
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The effects of Medicaid managed care vary with the type of program, and policy makers should not expect programs that rely on PCCMs to have the same effects as those that incorporate mandatory HMO enrollment.
Medicaid Managed Care and Cost Containment in the Adult Disabled Population
Medicaid MCO programs as implemented are not associated with lower Medicaid spending; thus, state Medicaid programs should consider additional policy tools to contain health care expenditures in this population.