Safety-net health plans: A status report

Health Affairs

Volumn 19, Issue 1, 2000, Pages 185-193

  Gray, Bradford H ^a   Rowe, Catherine ^a  

^a NEW YORK ACADEMY OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FINANCIAL MANAGEMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICES RESEARCH; HUMAN; MEDICAID; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PATIENT; POVERTY; QUESTIONNAIRE; UNITED STATES;

FINANCIAL MANAGEMENT; HEALTH POLICY; HEALTH SERVICES RESEARCH; HUMANS; MANAGED CARE PROGRAMS; MEDICAID; MEDICALLY UNINSURED; ORGANIZATIONAL OBJECTIVES; POVERTY; QUESTIONNAIRES; STATE HEALTH PLANS; UNITED STATES;

EID: 0008566734     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.1.185     Document Type: Article

References (11)

1. For a recent overview of Medicaid managed care, see S. Davidson and S. Somers, eds., Remaking Medicaid: Managed Care for the Public Good (San Francisco: Jossey-Bass, 1998). See also Alpha Center, Medicaid Managed Care and Safety-Net Providers: A Technical Assistance Guide for Managed Care Organizations (Washington: Alpha Center, April 1998).
2. For a recent overview of Medicaid managed care, see S. Davidson and S. Somers, eds., Remaking Medicaid: Managed Care for the Public Good (San Francisco: Jossey-Bass, 1998). See also Alpha Center, Medicaid Managed Care and Safety-Net Providers: A Technical Assistance Guide for Managed Care Organizations (Washington: Alpha Center, April 1998).
3. See M. McCue et al., "Reversal of Fortune: Commercial HMOs in the Medicaid Market," Health Affairs (Jan/Feb 1999): 223-230; and S. Felt-Lisk, The Changing Medicaid Managed Care Market: Trends in Commercial Plans' Participation (Washington: Kaiser Commission on Medicaid and the Uninsured, May 1999).
4. See M. McCue et al., "Reversal of Fortune: Commercial HMOs in the Medicaid Market," Health Affairs (Jan/Feb 1999): 223-230; and S. Felt-Lisk, The Changing Medicaid Managed Care Market: Trends in Commercial Plans' Participation (Washington: Kaiser Commission on Medicaid and the Uninsured, May 1999).
5. However, the New York State Coalition of PSHPs (Safety-Net Plans: The Role of Provider-Sponsored Health Plans in Maintaining the Safety-Net in a Managed Care Era, February 1998) did an in-depth study of seven safety-net plans in five states and investigated "unique approaches" in five other states. S. Felt-Lisk and S. Yang, "Changes in Health Plans Serving Medicaid, 1993-1996," Health Affairs (Sep/Oct 1997): 125-133, identified all fully capitated Medicaid managed care plans from HCFA and industry data.
6. However, the New York State Coalition of PSHPs (Safety-Net Plans: The Role of Provider-Sponsored Health Plans in Maintaining the Safety-Net in a Managed Care Era, February 1998) did an in-depth study of seven safety-net plans in five states and investigated "unique approaches" in five other states. S. Felt-Lisk and S. Yang, "Changes in Health Plans Serving Medicaid, 1993-1996," Health Affairs (Sep/Oct 1997): 125-133, identified all fully capitated Medicaid managed care plans from HCFA and industry data.
7. Because we had no access to data about the number of uninsured and Medicaid patients served by sponsors, this definition of safety net differs from that used in other studies. See K. Gautam, C. Campbell, and B. Arrington, "Financial Performance of Safety-Net Hospitals in a Changing Health Care Environment," Health Services Management Research (September 1996): 156-171; and Alpha Center, Medicaid Managed Care and Safety-Net Providers.
8. Seventeen percent of plans reported startup funds from sources other than equity or debt, including in-kind contributions from sponsors, cash advances from county government, and lines of credit or other arrangements with sponsors.
9. Health Care Financing Administration, National Summary of Medicaid Managed Care Programs and Enrollment (Baltimore: HCFA, 30 June 1998).
10. InterStudy Competitive Edge Part II: HMO Industry Report 8.2 (October 1998), 59.
11. This issue pertains to the difficulties plans face in managing the care of enrollees who enter and leave plans quickly because of changes in Medicaid eligibility or who can disenroll from plans after a short period.