Literature DB >> 21675383

Assessing the financial health of Medicaid managed care plans and the quality of patient care they provide.

Michael J McCue1, Michael H Bailit.   

Abstract

In many states, Medicaid programs have contracted out the delivery of health care services to publicly traded health plans that are focused on managing the care of Medicaid members. Under the health reform law, states will be expanding the enrollment of their Medicaid programs and these publicly traded companies are expected to capitalize on this growing market. This study examined how publicly traded health plans differ from non-publicly traded ones in terms of administrative expenses, quality of care, and financial stability and found publicly traded plans that focused primarily on Medicaid enrollees paid out the lowest percentage of their Medicaid premium revenues in medical expenses and reported the highest percentage in administrative expenses across different types of health plans. The publicly traded plans also received lower scores for quality-of care measures related to preventive care, treatment of chronic conditions, members' access to care, and customer service.

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Year:  2011        PMID: 21675383

Source DB:  PubMed          Journal:  Issue Brief (Commonw Fund)        ISSN: 1558-6847


  4 in total

1.  The Impact of Medicaid Managed Care Plan Type on Continuous Medicaid Enrollment: A Natural Experiment.

Authors:  Sarah H Gordon; Yoojin Lee; Chima D Ndumele; Patrick M Vivier; Roee Gutman; Shailender Swaminathan; Emily A Gadbois; Renee R Shield; Amy Jo Haavisto Kind; Amal N Trivedi
Journal:  Health Serv Res       Date:  2018-06-27       Impact factor: 3.402

2.  Financial performance of health plans in Medicaid managed care.

Authors:  Mike McCue
Journal:  Medicare Medicaid Res Rev       Date:  2012-06-29

3.  Effects of forced disruption in Medicaid managed care on children with asthma.

Authors:  Katherine Piwnica-Worms; Becky Staiger; Joseph S Ross; Marjorie S Rosenthal; Chima D Ndumele
Journal:  Health Serv Res       Date:  2021-02-23       Impact factor: 3.734

4.  Association of Medicaid-Focused or Commercial Medicaid Managed Care Plan Type With Outpatient and Acute Care.

Authors:  Shailender Swaminathan; Chima D Ndumele; Sarah H Gordon; Yoojin Lee; Amal N Trivedi
Journal:  JAMA Intern Med       Date:  2020-12-01       Impact factor: 21.873

  4 in total

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