Marguerite E Burns1. 1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts 02215, USA. marguerite_burns@harvardpilgrim.org
Abstract
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.
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: Jeffrey S Harman; Christy H Lemak; Mona Al-Amin; Allyson G Hall; Robert Paul Duncan Journal: Health Serv Res Date: 2011-01-06 Impact factor: 3.402
Authors: Martin P Wegman; Jill B Herndon; Keith E Muller; Garth N Graham; W Bruce Vogel; Kimberly H Case; Jason A Lee; Matthew F Van Voorhis; Elizabeth A Shenkman Journal: Med Care Date: 2015-07 Impact factor: 2.983