Abstract
OBJECTIVE: To assess the impact of switching from a fee-for-service (FFS) delivery system to managed care on access to, use of, and satisfaction with health care for children. DATA SOURCES/STUDY SETTING: A 1998 survey of Medicaid recipients in rural Minnesota. STUDY DESIGN: Using a quasi-experimental framework, we compare the experiences of children on Medicaid living in counties that had switched to managed care with those of children living in counties operating under FFS Medicaid. We address the impact of Medicaid managed care (MMC) on access to, use of, and satisfaction with care. DATA COLLECTION METHODS: A stratified random sample of children on Medicaid was drawn based on Medicaid enrollment files. Telephone interviews were conducted with the child's parent or guardian between March and June 1998. An overall response rate of 70 percent was achieved, yielding a sample of 1,106 children (814 in MMC and 792 in Medicaid FFS). PRINCIPAL FINDINGS: We find very few significant differences in access to, use of, or satisfaction with health care services for children under MMC relative to FFS. MMC did not change the patterns of health care service use or the location at which care is delivered, two major goals of MMC initiatives. CONCLUSIONS: Our results suggest that the Medicaid program's shift from FFS to managed care had little impact on the pattern of children's health care use, the location at which they obtained care, or the satisfaction with the care they received.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abrams R., Savela T., Trinity M. T., Falik M., Tutunjian B., Ulmer C. Performance of community health centers under managed care. J Ambul Care Manage. 1995 Jul;18(3):77–88. doi: 10.1097/00004479-199507000-00010. [DOI] [PubMed] [Google Scholar]
- Andersen R., Aday L. A. Access to medical care in the U.S.: realized and potential. Med Care. 1978 Jul;16(7):533–546. doi: 10.1097/00005650-197807000-00001. [DOI] [PubMed] [Google Scholar]
- Coughlin T. A., Long S. K. Effects of medicaid managed care on adults. Med Care. 2000 Apr;38(4):433–446. doi: 10.1097/00005650-200004000-00010. [DOI] [PubMed] [Google Scholar]
- Deal L. W., Shiono P. H., Behrman R. E. Children and managed health care: analysis and recommendations. Future Child. 1998 Summer-Fall;8(2):4–24. [PubMed] [Google Scholar]
- Felt-Lisk S., Silberman P., Hoag S., Slifkin R. Medicaid managed care in rural areas: a ten-state follow-up study. Health Aff (Millwood) 1999 Mar-Apr;18(2):238–245. doi: 10.1377/hlthaff.18.2.238. [DOI] [PubMed] [Google Scholar]
- Freund D. A., Rossiter L. F., Fox P. D., Meyer J. A., Hurley R. E., Carey T. S., Paul J. E. Evaluation of the Medicaid competition demonstrations. Health Care Financ Rev. 1989 Winter;11(2):81–97. [PMC free article] [PubMed] [Google Scholar]
- Heinen L., Fox P. D., Anderson M. D. Findings from the Medicaid Competition Demonstrations: a guide for states. Health Care Financ Rev. 1990 Summer;11(4):55–67. [PMC free article] [PubMed] [Google Scholar]
- Hudson T. Rural priorities. Hospital links and managed care contracts top the list. Hosp Health Netw. 1995 Feb 20;69(4):40–44. [PubMed] [Google Scholar]
- Hughes D. C., Luft H. S. Managed care and children: an overview. Future Child. 1998 Summer-Fall;8(2):25–38. [PubMed] [Google Scholar]
- Mauldon J., Leibowitz A., Buchanan J. L., Damberg C., McGuigan K. A. Rationing or rationalizing children's medical care: comparison of a Medicaid HMO with fee-for-service care. Am J Public Health. 1994 Jun;84(6):899–904. doi: 10.2105/ajph.84.6.899. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oleske D. M., Branca M. L., Schmidt J. B., Ferguson R., Linn E. S. A comparison of capitated and fee-for-service Medicaid reimbursement methods on pregnancy outcomes. Health Serv Res. 1998 Apr;33(1):55–73. [PMC free article] [PubMed] [Google Scholar]