The expanding role of managed care in the Medicaid program: Implications for health care access, use, and expenditures for nonelderly adults

Inquiry (United States)

Volumn 52, Issue , 2015, Pages

  Caswell, Kyle J ^a   Long, Sharon K ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

Access to health care; Health care costs; Health care utilization; Managed care; Medicaid

Indexed keywords

DEMOGRAPHY; DISABILITY; ECONOMICS; EMERGENCY HEALTH SERVICE; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH INSURANCE; HEALTH SERVICE; HUMAN; INSURANCE; MEDICAID; PRESCRIPTION; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES; UTILIZATION;

DEMOGRAPHY; DISABILITY EVALUATION; DRUG PRESCRIPTIONS; EMERGENCY SERVICE, HOSPITAL; HEALTH EXPENDITURES; HEALTH SERVICES; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; INSURANCE COVERAGE; MANAGED CARE PROGRAMS; MEDICAID; UNITED STATES;

EID: 84982728073     PISSN: 00469580     EISSN: 19457243     Source Type: Journal    
DOI: 10.1177/0046958015575524     Document Type: Article

References (33)

1. Sparer M. Medicaid Managed Care: Costs, Access, and Quality of Care. Princeton, NJ: Robert Wood Johnson Foundation; 2012. Research Synthesis Report 23. http://media.khi.org/news/documents/2013/01/14/managed-care-rwjf.pdf. Accessed February 7, 2015.
2. Smith VK, Gifford K, Ellis E, Rudowitz R, Snyder L. Medicaid Today; Preparing for Tomorrow A Look at State Medicaid Program Spending, Enrollment and Policy Trends. Washington, DC: Kaiser Commission on Medicaid and the Uninsured; 2012.
3. Silow-Carroll S, Edwards J, Rodin D. State Levers for Improving Managed Care for Vulnerable Populations: Strategies With Medicaid MCOs and ACOs. Lansing, MI: Health Management Associates; 2013.
4. Centers for Medicare and Medicaid Services (CMS). Number of Managed Care Entity Enrollees by State as of July 1, 2010. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/Medicaid-Managed-Care/Downloads/managed-care-enrollees-by-state-07012010.pdf.Accessed February 7, 2015.
5. Herring B, Adams EK. Using HMOs to serve the Medicaid population: what are the effects on utilization and does the type of HMO matter? Health Econ. 2011;4(20):446-460. doi:10.1002/hec.1602.
6. Duggan M, Hayford T. Has the shift to managed care reduced Medicaid expenditures? evidence from state and locallevel mandates. J Policy Anal Manag. 2013;32(3):505-535. doi:10.1002/pam.21693.
7. Kirby J, Machlin S, Cohen J. Has the increase in HMO enrollment within the Medicaid population changed the pattern of health service use and expenditures? Med Care. 2003;41(7):III24-III34. http://journals.lww.com/lwwmedicalcare/Fulltext/2003/07001/Effects_of_Medicaid_Managed_Care_on_Adults.4.aspx.Accessed February 7, 2015.
8. Burns ME. Medicaid managed care and cost containment in the adult disabled population. Med Care. 2009;47(10):1069-1076. doi:10.1097/MLR.0b013e3181a80fef.
9. Marton J, Yelowitz A, Talbert JC. A tale of two cities? the heterogeneous impact of Medicaid managed care. J Health Econ. 2014;36:47-68. doi:10.1016/j.jhealeco.2014.03.001.
10. Duggan M. Does contracting out increase the efficiency of government programs? evidence from Medicaid HMOs. J Public Econ. 2004;88(12):2549-2572. http://www.sciencedirect.com/science/article/pii/S0047272703001415.Accessed February 7, 2015.
11. Garrett B, Zuckerman S. National estimates of the effects of mandatory Medicaid managed care programs on health care access and use, 1997-1999. Med Care. 2005;43(7):649-657. doi:10.1097/01.mlr.0000167105.75204.71.
12. Burns ME. Medicaid managed care and health care access for adult beneficiaries with disabilities. Health Serv Res. 2009;44 (5, pt 1):1521-1541. http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2009.00991.x/full.Accessed February 7, 2015.
13. Coughlin TA, Long SK, Graves JA. Does managed care improve access to care for Medicaid beneficiaries with disabilities? A national study. Inquiry. 2008;45(4):395-407. doi:10.5034/inquiryjrnl_45.04.395.
14. MSIS-Medicaid Statistical Information System. http://www.medicaid.gov/medicaid-chip-program-information/by-topics/data-and-systems/msis/medicaid-statistical-information-system. html. Accessed March 12, 2015.
15. Centers for Disease Control and Prevention (CDC). BRFSS-Behavioral Risk Factor Surveillance System. http://www.cdc.gov/brfss/. Accessed February 7, 2015.
16. AHRF: Area Health Resources Files. http://ahrf.hrsa.gov/.Accessed February 7, 2015.
17. FRED-Federal Reserve Economic Data-St. Louis Fed. http://research.stlouisfed.org/fred2/.Accessed February 7, 2015.
18. US Census Bureau. State Government Finances. http://www.census.gov/govs/state/. Accessed February 7, 2015.
19. Ross D, Jarlenski M, Artiga S, Marks C. A Foundation for Health Reform: Findings of a 50 State Survey of Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid. Washington, DC: Kaiser Family Foundation; 2009.
20. US Census Bureau. SAIPE, Small Area Income and Poverty Estimates. http://www.census.gov/did/www/saipe/.Accessed February 7, 2015.
21. Centers for Medicare and Medicaid Services (CMS). 2010 National Summary of State Medicaid Managed Care Programs as of July 1, 2010. http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/downloads/2010NationalSummaryPub.pdf. Accessed February 7, 2015.
22. Centers for Medicare and Medicaid Services (CMS). Medicaid Managed Care Enrollment Report, Summary Statistics as of July 1, 2011. http://www.medicaid.gov/medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/Downloads/2011-Medicaid-MC-Enrollment-Report.pdf.Accessed February 7, 2015.
23. Chernew M, Gowrisankaran G, McLaughlin C, Gibson T. Quality and employers' choice of health plans. J Health Econ. 2004;23:471-492. doi:10.1016/j.jhealeco.2003.09.010.
24. Baker L. The effect of HMOs on fee-for-service health care expenditures: evidence from Medicare. J Health Econ. 1997;6(4):453-481. http://www.sciencedirect.com/science/article/pii/S0167629696005358.Accessed February 7, 2015.
25. Baker L. Association of managed care market share and health expenditures for fee-for-service Medicare patients. JAMA. 1999;281(5):432-437. doi:10.1001/jama.281.5.432.
26. Bundorf MK, Schulman KA, Stafford JA, Gaskin D, Jollis JG, Escarce JJ. Impact of managed care on the treatment, costs, and outcomes of fee-for-service Medicare patients with acute myocardial infarction. Health Serv Res. 2004;39(1):131-152. doi:10.1111/j.1475-6773.2004.00219.x.
27. US Department of Commerce, Bureau of Economic Analysis. National Income and Product Accounts Tables, Table 1.1.4, Price Indexes for Gross Domestic Product. http://bea.gov/iTable/iTable.cfm?ReqID=9&step=1#reqid=9&step=3&isuri=1&903=4. Accessed February 7, 2015.
28. US Department of Labor, Bureau of Labor Statistics. Consumer Price Index-All Urban Consumers, U.S. All Items, 1982-84=100-CUUR0000SA0. http://data.bls.gov/cgi-bin/surveymost?cu.Accessed February 7, 2015.
29. Social Security Administration. Understanding Supplemental Security Income (SSI)-SSI and Eligibility for Other Government and State Programs. http://www.socialsecurity.gov/ssi/text-other-ussi.htm. Accessed February 7, 2015.
30. Adult Self-Administered Questionnaire (AHRQ). Adult Self-Administered Questionnaire 2010. http://meps.ahrq.gov/mepsweb/survey_comp/hc_survey/paper_quest/2010/2010_SAQ_ENG.shtml.Accessed February 7, 2015.
31. Adult Self-Administered Questionnaire (AHRQ). MEPS HC-138: 2010 Full Year Consolidated Data File. http://meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h138/h138doc.shtml. Accessed February 7, 2015.
32. Besley T, Case A. Unnatural experiments? estimating the incidence of endogenous policies. Econ J. 2000;110:F672-F694. http://www.blackwellpublishing.com/journal.asp?ref=0013-0133.Accessed February 26, 2015.
33. Monheit AC, Cantor JC, Delia D, Belloff D. How have state policies to expand dependent coverage affected the health insurance status of young adults? Health Serv Res. 2011;46(1, pt 2):251-267. doi:10.1111/j.1475-6773.2010.01200.x.