Can states stretch the medicaid dollar without passing the buck? Lessons from Utah

Health Affairs

Volumn 25, Issue 2, 2006, Pages 532-540

  Artiga, Samantha ^a   Rousseau, David ^b   Lyons, Barbara ^b   Smith, Stephen ^c   Gaylin, Daniel S ^d  

^a Kaiser Commission on Medicaid and the Uninsured   (United States)

^b KFF ^*

^c University of Chicago   (United States)

^d NORC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; CHRONIC DISEASE; COST; DISABLED PERSON; ECONOMICS; EPIDEMIOLOGY; FINANCIAL MANAGEMENT; HEALTH CARE DELIVERY; HEALTH CARE PLANNING; HUMAN; LEGAL ASPECT; MEDICAID; MEDICAL FEE; MIDDLE AGED; POVERTY; PRIMARY HEALTH CARE; REVIEW; STATISTICS; UNITED STATES;

ADULT; CHRONIC DISEASE; COST SHARING; DISABLED PERSONS; FEES, MEDICAL; FINANCING, PERSONAL; HEALTH CARE SURVEYS; HEALTH SERVICES ACCESSIBILITY; HUMANS; MEDICAID; MIDDLE AGED; POVERTY; PRIMARY HEALTH CARE; STATE HEALTH PLANS; UNITED STATES; UTAH;

EID: 33645690564     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.25.2.532     Document Type: Review

References (20)

1. M. Leavitt, "Medicaid: A Time to Act" (Address to the World Health Care Congress, Washington, D.C., 1 February 2005), http://www.hhs.gov/ news/speech/2005/050201.html (accessed. 17 October 2005).
2. National Governors Association, "Medicaid Reform: A Preliminary Report," 15 June 2005, http://www.nga.org/Files/pdf/0506Medicaid.pdf (accessed 9 January 2005).
3. S. Artiga and C. Mann, New Policy Directions for Medicaid Section 1115 Waivers; Policy Implications of Recent Waiver Activity, March 2005, http://www.kff.org/medicaid/7286.cfm (accessed 25 January 2006).
4. The reductions enabled the state to meet the federal government's budget-neutrality requirement for the waiver. For state financing, the state relied on the reductions as well as funding from the fully state-funded Utah Medical Assistance Program, which was eliminated when the PCN was implemented.
5. C. Oppenheimer et al., A Case Study of the Utah Section 1115 Primary Care Network Waiver; Insights into Its Development, Design, and Implementation (Washington: Kaiser Commission on Medicaid and the Uninsured, forthcoming).
6. C. Oppenheimer et al., A Case Study of the Utah Section 1115 Primary Care Network Waiver; Insights into Its Development, Design, and Implementation, Ibid.
7. C. Oppenheimer et al., A Case Study of the Utah Section 1115 Primary Care Network Waiver; Insights into Its Development, Design, and Implementation, Ibid.
8. Utah Department of Health, "PCN-CAW Enrollment 6-26-04," from PCN Program Manager Heidi Weaver, March 2005.
9. PCN-CAW Enrollment 6-26-04, 2005, Ibid.
10. Utah Department of Health, "PCN-CAW Enrollment 5-28-05," from Heidi Weaver, June 2005. Data for nonelderly uninsured adults from 2002-03 based on Urban Institute/Kaiser Commission analysis of Current Population Surveys, March 2003 and March 2004 (unpublished).
11. This yielded a sampling frame of 13,756 PCN enrollees and 13,191 Non-Traditional Medicaid enrollees. Those who were no longer enrolled at the time of the interview were excluded, resulting in a weighted population of 10,004 PCN enrollees and 10,262 Non-Traditional Medicaid enrollees. Portions of the analysis that were limited to those who had been enrolled for one calendar year used a weighted twelve-month eligible population of 7,983 PCN enrollees and 10,087 Non-Traditional Medicaid enrollees.
12. Response and cooperation rates were calculated according to the American Association for Public Opinion Research's (AAPOR's) RR3 response rate formula and COOP1 cooperation rate formula. Response rates above 40 percent for telephone surveys of Medicaid respondents are generally considered acceptable, given the challenges involved in surveying this population. See R. Hays et al., "Psychometric Properties of the CAHPS 1.0 Survey Measures," Medical Care 37, no. 3 Supp. (1999): MS22-MS31.
13. The mean duration between date of enrollment and date of interview was 16.7 months for PCN enrollees and 51.6 months for Non-Traditional Medicaid enrollees.
14. Kaiser Commission/Urban Institute analysis of CPS data, March 2003 and March 2004.
15. Unpublished analysis of adults ages 19-64 with incomes less than 150 percent of poverty using data from the Center for Studying Health System Change's 2003 Community Tracking Study Household Survey, 2003, http://www.hschange.org/index.cgi?data42 (accessed 21 December 2005).
16. Artiga and Mann, New Policy Directions.
17. Artiga and Mann, New Policy Directions. Ibid.
18. and S. Artiga and M. O'Malley, Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent Stcrte Experiences, May 2005, http://www.kff.org/ medicaid/7322.cfm (accessed 25 January 2006).
19. J. Hadley and J. Holahan, "Is Health Care Spending Higher under Medicaid or Private Insurance?" Inawry 40, no. 4 (2003): 323-342.
20. J. Holahan and A. Ghosh, "Understanding the Recent Growth in Medicaid Spending, 2000-2003," Health Affairs 24 (2005): w52-w62 (published online 26 January 2005; 10.1377/hlthaff.w5.52).