| Medicaid managed care and cost containment in the adult disabled population. | |
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MedLine Citation:
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PMID: 19820613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Marguerite E Burns |
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Publication Detail:
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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:
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Title: Medical care Volume: 47 ISSN: 1537-1948 ISO Abbreviation: Med Care Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-12 Completed Date: 2009-12-03 Revised Date: 2011-01-25 |
Medline Journal Info:
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Nlm Unique ID: 0230027 Medline TA: Med Care Country: United States |
Other Details:
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Languages: eng Pagination: 1069-76 Citation Subset: IM |
Affiliation:
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Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts 02215, USA. marguerite_burns@harvardpilgrim.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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