| Literature DB >> 29248057 |
James Marton1, Aaron Yelowitz2, Jeffery C Talbert3.
Abstract
In 2012, Kentucky implemented Medicaid managed care statewide, auto-assigned enrollees to three plans, and allowed switching. Using administrative data, we find that the state's auto-assignment algorithm most heavily weighted cost-minimization and plan balancing, and placed little weight on the quality of the enrollee-plan match. Immobility - apparently driven by health plan inertia - contributed to the success of the cost-minimization strategy, as more than half of enrollees auto-assigned to even the lowest quality plans did not opt-out. High-cost enrollees were more likely to opt-out of their auto-assigned plan, creating adverse selection. The plan with arguably the highest quality incurred the largest initial profit margin reduction due to adverse selection prior to risk adjustment, as it attracted a disproportionate share of high-cost enrollees. The presence of such selection, caused by differential degrees of mobility, raises concerns about the long run viability of the Medicaid managed care market without such risk adjustment.Entities:
Keywords: Adverse selection; Inertia; Managed care; Medicaid
Mesh:
Year: 2017 PMID: 29248057 DOI: 10.1016/j.jhealeco.2017.04.006
Source DB: PubMed Journal: J Health Econ ISSN: 0167-6296 Impact factor: 3.883