Document Detail


Medicaid managed care and cost containment in the adult disabled population.
MedLine Citation:
PMID:  19820613     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite the increasing enrollment of adult disabled beneficiaries into Medicaid managed care organizations (MCOs), there is little evidence of its (hoped for) effectiveness at reducing Medicaid expenditures.
OBJECTIVE: : To evaluate the impact of Medicaid MCOs on health care expenditures for adults with disabilities.
RESEARCH DESIGN: I employ a repeated observations design comparing individual monthly Medicaid expenditures across beneficiaries who reside in counties with mandatory, voluntary, and no MCOs. County-level Medicaid MCO program status for adults with disabilities was merged with the Medical Expenditure Panel Survey and the Area Resource File for 1996-2004. Two-part regression models are used to estimate the probability and level of Medicaid expenditure.
SUBJECTS: Working age Medicaid beneficiaries who receive Supplement Security Income for disability comprise the sample of 1613 individuals.
MEASURES: Outcome measures include total and service-specific Medicaid expenditures.
RESULTS: On average, total monthly Medicaid expenditures per beneficiary do not differ between FFS and MCO counties although some service-specific spending differs. Relative to FFS counties, average monthly Medicaid spending per beneficiary is higher for prescription medications in voluntary ($24) and mandatory ($25) MCO counties. Average Medicaid monthly spending for other medical care and dental care is $4 to $11 higher per beneficiary in MCO relative to FFS counties.
CONCLUSIONS: Medicaid MCO programs as implemented are not associated with lower Medicaid spending; thus, state Medicaid programs should consider additional policy tools to contain health care expenditures in this population.
Authors:
Marguerite E Burns
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Medical care     Volume:  47     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2009-12-03     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-76     Citation Subset:  IM    
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts 02215, USA. marguerite_burns@harvardpilgrim.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cost Control*
Disabled Persons*
Health Expenditures / statistics & numerical data*
Health Services Research
Humans
Managed Care Programs / organization & administration*,  statistics & numerical data
Medicaid / organization & administration*,  statistics & numerical data
Middle Aged
Models, Economic*
Regression Analysis
United States
Grant Support
ID/Acronym/Agency:
T32 000083//PHS HHS; T32 HS000083-12/HS/AHRQ HHS; T32 MH018029-22/MH/NIMH NIH HHS; T32 MH18029-22/MH/NIMH NIH HHS; UL1 RR025011-01/RR/NCRR NIH HHS; UL1 RR025011-02/RR/NCRR NIH HHS; UL1 RR025011-03/RR/NCRR NIH HHS
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