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. Author manuscript; available in PMC: 2019 Jan 1.
Published in final edited form as: Med Care. 2018 Jan;56(1):54–61. doi: 10.1097/MLR.0000000000000844

TABLE 5.

Medicaid Relative to Private Insurance Fees and Utilization of Immunization Services by Children

N =1,678,288† State MCP Rate <0.4 (N =645,243)‡
At Least 1 Vaccination Visit
in the Year
PP (95% CI)		 No. Vaccination Visits
in the Year
Coefficients (95% CI)		 At Least 1 Vaccination Visit
in the Year
PP (95% CI)		 No. Vaccination Visits
in the Year
Coefficients (95% CI)
(Medicaid fees/private fees)×100 0.06 (−0.00 to 0.12)* 0.00 (−0.00 to 0.01) 0.17 (0.02–0.31)** 0.01 (0.00–0.01)**
Age group (reference: 0–3 y)
  4–6 −14.67 (−18.59 to −10.76)*** −1.40 (−1.71 to −1.08)*** −16.57 (−23.48 to −9.65)*** −1.36 (−1.85 to −0.87)***
  7–10 −32.17 (−38.07 to −26.28)*** −2.01 (−2.49 to −1.52)*** −34.36 (−43.83 to −24.89)*** −1.86 (−2.48 to −1.24)***
  11–17 −27.41 (−33.16 to −21.66)*** −1.82 (−2.29 to −1.36)*** −29.23 (−40.45 to −18.02)*** −1.66 (−2.14 to −1.19)***
Males −1.43 (−2.20 to −0.65)*** −0.04 (−0.07 to −0.01)*** −1.92 (−3.39 to −0.45)** −0.05 (−0.11 to −0.00)**
Race/ethnicity (reference: non-Hispanic other race)
  Non-Hispanic white −1.91 (−8.15 to 4.33) 0.04 (−0.15 to 0.22) −0.98 (−11.73 to 9.78) 0.08 (−0.22 to 0.38)
  Non-Hispanic black 0.71 (−7.74 to 9.15) 0.07 (−0.27 to 0.40) 6.47 (−6.94 to 19.88) 0.25 (−0.09 to 0.59)
  Hispanic −0.46 (−9.30 to 8.37) 0.04 (−0.24 to 0.33) 2.21 (−13.52 to 17.95) 0.13 (−0.31 to 0.57)
State MCP rate 0.36 (−0.02 to 0.74)* 0.01 (−0.01 to 0.03) 0.23 (0.07 to 0.39)** 0.01 (0.00 to 0.02)**
State unemployment rate 0.35 (−1.72 to 2.43) 0.02 (−0.11 to 0.14) −1.33 (−6.42 to 3.76) −0.06 (−0.30 to 0.18)

All regressions included age group, sex, race/ethnicity, state MCP rate, state unemployment rate, and state and year-fixed effects as control variables.

†

The analysis included Medicaid-enrolled children aged 0–17 years, continuously enrolled in a Medicaid FFS plan, and resided in the 8 states with a MCP rate <75%.

‡

The analysis included Medicaid-enrolled children aged 0–17 years, continuously enrolled in a Medicaid FFS plan, and resided in the 4 states with a MCP rate <40%.

CI indicates confidence interval; FFS, fee-for-service; MCP, managed-care penetration; PP, percentage point.

*

P < 0.1.

**

P < 0.05.

***

P < 0.01.