Churning in Medicaid managed care and its effect on accountability

Journal of Health Care for the Poor and Underserved

Volumn 15, Issue 1, 2004, Pages 30-41

  Fairbrother, Gerry ^a   Jain, Aparna ^a   Park, Heidi L ^a   Massoudi, Mehran S ^b   Haidery, Arfana ^a   Gray, Bradford H ^a  

^a NEW YORK ACADEMY OF MEDICINE   (United States)

^b CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

Author keywords

Accountability; Churning; Health Plan Employer Data and Information Set; Immunizations; Medicaid managed care

Indexed keywords

ACCOUNTING; ARTICLE; HEALTH CARE MANAGEMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; IMMUNIZATION; MEDICAID; MEDICARE;

EID: 2142656497     PISSN: 10492089     EISSN: None     Source Type: Journal    
DOI: 10.1353/hpu.2004.0003     Document Type: Article

References (27)

1. Centers for Medicare and Medicaid Services. 2001 Medicaid Managed Care Enrollment Report: Penetration rates from 1996-2001: National Summary Table (Retrieved March 2003) [Online]. Available: www.cms.gov/medicaid/managedcare/ trends01.pdf.
2. National Committee for Quality Assurance (NCQA). NCQA overview: Measuring the quality of America's health care. Washington, DC: National Committee for Quality Assurance, 2002.
3. Iglehart JK. The National Committee For Quality Assurance. N Engl J Med 1996 Sep 26;335(13):995-9.
4. National Committee for Quality Assurance. Health plan employer data & information set. Washington, DC: National Committee for Quality Assurance, 2002.
5. Agency for Healthcare Research and Quality. Child Health Toolbox: Measuring Performance in Child Health Programs. Established Child Health Measures. HEDIS®: Health Plan Employer Data and Information Set (Retrieved March 2003) [Online]. Available: www.ahrq.gov/chtoolbx/measure4.htm.
6. Atkinson W, Furphy, L, Humiston, SG, et al, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases: The Pink Book. Atlanta, GA: Centers For Disease Control And Prevention, 1997.
7. National Committee for Quality Assurance. Health plan employer data & information set. Washington, DC: National Committee for Quality Assurance, 1996.
8. Landon BE, Tobias C, Epstein AM. Quality management by state Medicaid agencies converting to managed care. JAMA 1998 Jan 21;279(3):211-6.
9. Bachrach D, Tassi A. Coverage gaps: The problem of enrollee churning In Medicaid Managed Care and Child Health Plus. New York, NY: Kalkines, Arky, Zall & Bernstein, 2000.
10. Dick AW, Allison A, Haber SG, et al. Consequences of states' policies for SCHIP disenrollment. Health Care Financ Rev 2002 Spring;23(3):65-88.
11. Medical Home Initiatives for Children with Special Needs Project Advisory Committee. American Academy of Pediatrics. The medical home. Pediatrics. 2002 Jul;110(1 Pt 1):184-6.
12. Lieu TA, Massoudi MR, Miroshnik IL, et al. Immunization status among children newly enrolled in a health plan: A new frontier for quality measurement? Am J Manag Care 2003 Feb;9(2):121-7.
13. Median income for 4-person families, by state. U.S. Census Bureau, 2002.
14. Census regions and divisions of the United States. U.S. Department of Commerce Economics and Statistics Administration, U.S. Census Bureau, 2002.
15. Annual population estimates by state. U.S. Census Bureau, 2002.
16. Urban and rural population: 1900 to 1990. U.S. Census Bureau, 1995.
17. McManus M, et al. How far have state Medicaid agencies advanced in performance measurement for children? Arch Pediatr Adolesc Med 2000 Jul;154(7):665-71.
18. Bradley EH, Horwitz SM, Grogan CM, et al. Monitoring clinical quality in Medicaid managed care. Conn Med 1998 Apr;62(4):215-20.
19. Carrasquillo O, Himmelstein DU, Wollhandler S, et al. Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid. Am J Public Health 1998 Mar;88(3):464-6.
20. Czajka JL. Analysis of children's health insurance patterns: Findings from the Survey of Income and Program Participation. Washington, DC: Mathematica Policy Research Inc., 1999.
21. Ellwood M. The Medicaid eligibility maze: Coverage expands, but enrollment problems persist. Washington, DC: The Kaiser Commission on Medicaid and the Uninsured. The Henry J. Kaiser Foundation, 1999.
22. Cohen Ross D, Cox L. Enrolling children and families in health coverage: The promise of doing more. Washington, DC: The Henry J. Kaiser Family Foundation, 2002.
23. Bachrach D, Belfort R, Lipson. Closing coverage gaps: Improving retention rates in New York's Medicaid and Child Health Plus programs. New York: Kalkines, Arky, Zall & Bernstein LLP, 2000.
24. Birnbaum M, Holahan D. Renewing coverage in New York's Child Health Plus B program: Retention rates and enrollee experiences. New York: United Hospital Fund, 2003.
25. Cohen Ross D, Cox L. Making it simple: Medicaid for children and CHIP income eligibility guidelines and enrollment procedures. Washington, DC: Center on Budget and Policy Priorities, 2000.
26. Curtis D. Medicaid Managed Care enrollment and disenrollment: The experience of four states. Portland, ME: National Academy for State Health Policy, 1999.
27. Riley T, Pernice C, Perry M, et al. Why eligible children lose or leave SCHIP: Findings from a comprehensive study of retention and disenrollment. Portland, ME: National Academy for State Health Policy, 2002.