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Essay on Impact of Managed care on Medicare and Medicaid
Abstract
A growing percentage of Medicaid patients are receiving medical care within a managed care system. This policy change has raised concerns about whether safety-net providers can maintain their share of patients. From 1995 to 1997 several of states’ counties implemented mandatory managed care. The majority of safety-net primary care clinics experienced a decline in the percentage of their patients insured. However, after the overall decline in the number of beneficiaries was controlled for, the increased penetration of managed care in a county was not independently associated with a decline in clinics’ share of patients. Despite this fact, it may become increasingly difficult for clinics to maintain their current level of services with declining enrollment and other anticipated reforms in their funding.
Executive Summary
America’s Health Insurance Plans1 engaged The Lewin Group to synthesize existing research on the savings achieved when states have implemented Medicaid managed care programs. The studies reviewed were identified and selected by America’s Health Insurance Plans and Lewin and include federally required independent assessments and studies commissioned by the federal and state governments and private foundations. Studies are grouped into three categories:
- State studies, which examine states’ cost savings in their overall Medicaid managed care programs
- Targeted Medicaid managed care studies, which assess savings in Medicaid managed care programs targeted to specific populations; and
- Specific service studies, which analyze Medicaid managed care program savings for specific services.
It is worth noting that, although not a focal point of this engagement, many of the studies reviewed addressed the impact of managed care on access and continuity of care as well as on costs. In the overwhelming majority of cases, the state Medicaid managed care programs were found to have improved Medicaid beneficiaries’ access to services, and both the programs and individual MCOs have earned.....
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