The evolution of quality management in medicaid managed care

Health Affairs

Volumn 23, Issue 4, 2004, Pages 245-254

  Landon, Bruce E ^a   Schneider, Eric C ^b   Tobias, Carol ^c   Epstein, Arnold M ^b  

^a BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^b HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^c BOSTON UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONTROLLED STUDY; EVOLUTION; GOVERNMENT; HEALTH CARE MANAGEMENT; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HEALTH PROGRAM; HUMAN; MEDICAID;

HEALTH SERVICES RESEARCH; HUMANS; MANAGED CARE PROGRAMS; MEDICAID; QUESTIONNAIRES; STATE GOVERNMENT; TOTAL QUALITY MANAGEMENT; UNITED STATES;

EID: 3242741187     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.4.245     Document Type: Article

References (34)

1. R.E. Hurley and S.A. Somers, "Medicaid and Managed Care: A Lasting Relationship?" Health Affairs 22, no. 1 (2003): 77-88; J.K. Iglehart, "Medicaid: The American Health Care System," New England Journal of Medicine 340, no. 5 (1999): 403-408; and D. Rowland and K. Hanson, "Medicaid: Moving to Managed Care," Health Affairs 15, no. 3 (1996): 150-152.
2. R.E. Hurley and S.A. Somers, "Medicaid and Managed Care: A Lasting Relationship?" Health Affairs 22, no. 1 (2003): 77-88; J.K. Iglehart, "Medicaid: The American Health Care System," New England Journal of Medicine 340, no. 5 (1999): 403-408; and D. Rowland and K. Hanson, "Medicaid: Moving to Managed Care," Health Affairs 15, no. 3 (1996): 150-152.
3. R.E. Hurley and S.A. Somers, "Medicaid and Managed Care: A Lasting Relationship?" Health Affairs 22, no. 1 (2003): 77-88; J.K. Iglehart, "Medicaid: The American Health Care System," New England Journal of Medicine 340, no. 5 (1999): 403-408; and D. Rowland and K. Hanson, "Medicaid: Moving to Managed Care," Health Affairs 15, no. 3 (1996): 150-152.
4. CMS, "National Summary of Medicaid Managed Care Programs and Enrollment," 30 June 1998, www.cms .gov/Medicaid/managedcare/trends98.pdf (22 April 2004); and B.E. Landon et al., "The Evolution of Quality Management by State Medicaid Agencies: A National Survey of States with Comprehensive Managed Care Programs," Joint Commission Journal on Quality Improvement 28, no. 2 (2002): 72-82.
5. CMS, "National Summary of Medicaid Managed Care Programs and Enrollment," 30 June 1998, www.cms .gov/Medicaid/managedcare/trends98.pdf (22 April 2004); and B.E. Landon et al., "The Evolution of Quality Management by State Medicaid Agencies: A National Survey of States with Comprehensive Managed Care Programs," Joint Commission Journal on Quality Improvement 28, no. 2 (2002): 72-82.
6. See, for example, B.E. Landon, C. Tobias, and A.M. Epstein, "Quality Management by State Medicaid Agencies Converting to Managed Care: Plans and Current Practice," Journal of the American Medical Association 279, no. 3 (1998): 211-216; B.E. Landon and A.M. Epstein, "Quality Management Practices in Medicaid Managed Care: A National Survey of Medicaid and Commercial Health Plans Participating in the Medicaid Program," Journal of the American Medical Association 282, no. 18 (1999): 1769-1775; and J.W. Fossett et al., "CHCS Resource Library: Can Medicaid Managed Care Be Managed?" www.chcs.org/publications3960/ publications_show.htm?doc_id=211343 (18 May 2004).
7. See, for example, B.E. Landon, C. Tobias, and A.M. Epstein, "Quality Management by State Medicaid Agencies Converting to Managed Care: Plans and Current Practice," Journal of the American Medical Association 279, no. 3 (1998): 211-216; B.E. Landon and A.M. Epstein, "Quality Management Practices in Medicaid Managed Care: A National Survey of Medicaid and Commercial Health Plans Participating in the Medicaid Program," Journal of the American Medical Association 282, no. 18 (1999): 1769-1775; and J.W. Fossett et al., "CHCS Resource Library: Can Medicaid Managed Care Be Managed?" www.chcs.org/publications3960/ publications_show.htm?doc_id=211343 (18 May 2004).
8. See, for example, B.E. Landon, C. Tobias, and A.M. Epstein, "Quality Management by State Medicaid Agencies Converting to Managed Care: Plans and Current Practice," Journal of the American Medical Association 279, no. 3 (1998): 211-216; B.E. Landon and A.M. Epstein, "Quality Management Practices in Medicaid Managed Care: A National Survey of Medicaid and Commercial Health Plans Participating in the Medicaid Program," Journal of the American Medical Association 282, no. 18 (1999): 1769-1775; and J.W. Fossett et al., "CHCS Resource Library: Can Medicaid Managed Care Be Managed?" www.chcs.org/publications3960/ publications_show.htm?doc_id=211343 (18 May 2004).
9. J. Boehm, "Confronting Health Care Purchasing Challenges within a New Framework," CHCS Issue Brief (Princeton, N.J.: Center for Health Care Strategies, 2001).
10. See, for example, A.T. Lo Sasso et al., "Beyond Cost: 'Responsible Purchasing' of Managed Care by Employers," Health Affairs 18, no. 6 (1999): 212-223; J. Maxwell, P. Temin, and C. Watts, "Corporate Health Care Purchasing among Fortune 500 Firms," Health Affairs 21, no. 3 (2001): 181-188; and Agency for Healthcare Research and Quality, Theory and Reality of Value-Based Purchasing, Pub. no. 98-0004 (Rockville, Md.: AHRQ, 1997).
11. See, for example, A.T. Lo Sasso et al., "Beyond Cost: 'Responsible Purchasing' of Managed Care by Employers," Health Affairs 18, no. 6 (1999): 212-223; J. Maxwell, P. Temin, and C. Watts, "Corporate Health Care Purchasing among Fortune 500 Firms," Health Affairs 21, no. 3 (2001): 181-188; and Agency for Healthcare Research and Quality, Theory and Reality of Value-Based Purchasing, Pub. no. 98-0004 (Rockville, Md.: AHRQ, 1997).
12. See, for example, A.T. Lo Sasso et al., "Beyond Cost: 'Responsible Purchasing' of Managed Care by Employers," Health Affairs 18, no. 6 (1999): 212-223; J. Maxwell, P. Temin, and C. Watts, "Corporate Health Care Purchasing among Fortune 500 Firms," Health Affairs 21, no. 3 (2001): 181-188; and Agency for Healthcare Research and Quality, Theory and Reality of Value-Based Purchasing, Pub. no. 98-0004 (Rockville, Md.: AHRQ, 1997).
13. Landon et al., "Quality Management Practices."
14. CMS, Medicaid Program: External Quality Review of Medicaid Managed Care, Final Rule, 24 January 2003, www.cms .gov/medicaid/managedcare/eqr12403.pdf (15 January 2004); and CMS, Medicaid Managed Care: New Provisions, Final Rule, 14 June 2002, www.cms.gov/medicaid/managedcare/f4136.pdf (15 January 2004).
15. CMS, Medicaid Program: External Quality Review of Medicaid Managed Care, Final Rule, 24 January 2003, www.cms .gov/medicaid/managedcare/eqr12403.pdf (15 January 2004); and CMS, Medicaid Managed Care: New Provisions, Final Rule, 14 June 2002, www.cms.gov/medicaid/managedcare/f4136.pdf (15 January 2004).
16. Landon et al., "The Evolution of Quality Management"; Landon et al., "Quality Management by State Medicaid Agencies"; and Landon et al., "Quality Management Practices."
17. Landon et al., "The Evolution of Quality Management"; Landon et al., "Quality Management by State Medicaid Agencies"; and Landon et al., "Quality Management Practices."
18. Landon et al., "The Evolution of Quality Management"; Landon et al., "Quality Management by State Medicaid Agencies"; and Landon et al., "Quality Management Practices."
19. National Committee for Quality Assurance, "The Health Plan Employer Data and Information Set (HEDIS)," www.ncqa.org/Programs/HEDIS/index.htm (20 January 2004).
20. Landon et al., "Quality Management by State Medicaid Agencies"; and Landon et al., "Quality Management Practices."
21. Landon et al., "Quality Management by State Medicaid Agencies"; and Landon et al., "Quality Management Practices."
22. J. Holahan, J.M. Wiener, and A.W. Lutzky, "Health Policy for Low-Income People: States' Responses to New Challenges," Health Affairs, 22 May 2002, content.healthaffairs.org/cgi/content/abstract/hlthaff.w2.187 (22 January 2004).
23. See, for example, M.A. Morrisey, "Competition in Hospital, and Health Insurance Markets: A Review and Research Agenda," Health Services Research 36, no. 1, Part 2 (2001): 191-221; and M. Casey, A. Knott, and I. Moscovice, "Medicare Minus Choice: The Impact of HMO Withdrawals on Rural Medicare Beneficiaries," Health Affairs 21, no. 3 (2002): 192-199.
24. See, for example, M.A. Morrisey, "Competition in Hospital, and Health Insurance Markets: A Review and Research Agenda," Health Services Research 36, no. 1, Part 2 (2001): 191-221; and M. Casey, A. Knott, and I. Moscovice, "Medicare Minus Choice: The Impact of HMO Withdrawals on Rural Medicare Beneficiaries," Health Affairs 21, no. 3 (2002): 192-199.
25. See, for example, P. Silberman et al., "Tracking Medicaid Managed Care in Rural Communities: A Fifty-State Follow-up," Health Affairs 21, no. 4 (2002): 255-263; and B.C. Vladeck, "Where the Action Really Is: Medicaid and the Disabled," Health Affairs 22, no. 1 (2003): 90-100.
26. See, for example, P. Silberman et al., "Tracking Medicaid Managed Care in Rural Communities: A Fifty-State Follow-up," Health Affairs 21, no. 4 (2002): 255-263; and B.C. Vladeck, "Where the Action Really Is: Medicaid and the Disabled," Health Affairs 22, no. 1 (2003): 90-100.
27. See, for example, S. Felt-Lisk, R. Dodge, and M. McHugh, Trends in Health Plans Serving Medicaid - 2000 Data Update (Washington: Kaiser Commission on Medicaid and the Uninsured, 2001); and T.A. Coughlin, S.K. Long, and J. Holahan, "Commercial Health Plan Participation in Medicaid Managed Care: An Examination of Six Markets," Inquiry 38, no. 1 (2001): 22-34.
28. See, for example, S. Felt-Lisk, R. Dodge, and M. McHugh, Trends in Health Plans Serving Medicaid - 2000 Data Update (Washington: Kaiser Commission on Medicaid and the Uninsured, 2001); and T.A. Coughlin, S.K. Long, and J. Holahan, "Commercial Health Plan Participation in Medicaid Managed Care: An Examination of Six Markets," Inquiry 38, no. 1 (2001): 22-34.
29. Landon et al., "Quality Management Practices."
30. M.R. Gold and J. Mittler, "'Second-Generation' Medicaid Managed Care: Can It Deliver?" Health Care Financing Review 22, no. 2 (2000): 29-47; and A.M. Epstein, "Medicaid Managed Care and High Quality: Can We Have Both?" Journal of the American Medical Association 278, no. 19 (1997): 1617-1621.
31. M.R. Gold and J. Mittler, "'Second-Generation' Medicaid Managed Care: Can It Deliver?" Health Care Financing Review 22, no. 2 (2000): 29-47; and A.M. Epstein, "Medicaid Managed Care and High Quality: Can We Have Both?" Journal of the American Medical Association 278, no. 19 (1997): 1617-1621.
32. Fosset, "Can Medicaid Managed Care Be Managed"; and M.B. Dyer, M. Bailit, and C. Kokenyesi, "Are Incentives Effective in Improving the Performance of Managed Care Plans?" CHCS Working Paper (Princeton, N.J.: CHCS, March 2002).
33. Fosset, "Can Medicaid Managed Care Be Managed"; and M.B. Dyer, M. Bailit, and C. Kokenyesi, "Are Incentives Effective in Improving the Performance of Managed Care Plans?" CHCS Working Paper (Princeton, N.J.: CHCS, March 2002).
34. See, for example, J.H. Hibbard et al., "Strategies for Reporting Health Plan Performance Information to Consumers: Evidence from Controlled Studies," Health Services Research 37, no. 2 (2002): 291-313.