Medicaid Managed Care

The Medicaid program has undergone close srutiny and come under intense examination due to the federal bugetary impasse of 1995/96. The program, many people would argue, is need of some type of reform. The proliferation of managed care into the Medicaid market is a part of the reform that has been brought into public focus. This folder includes some useful Medicaid information as it pertains to managed care. It includes a basic managed care glossary, some large medical Web sites, and several documents pertaining to state Medicaid managed care issues.

Documents

Evaluating Medicaid Managed Care for Children - Review 11/94
Article review from the American Jounral of Public Health, "Rationing or Rationalizing Children's Medical Care: Comparison of a Medicaid HMO with Fee-for-Service Care". This is a review of the RWJ Foundation study under its program for Prepaid Managed Health Care and the effects of capitation within the Medicaid population. What is appealing about this document is that it is simply the review article and it summarized the journal article very adequately. It is short, concise, and to the point; however, it also contains very informative material. On the downside, if the reader wishes to access the entire journal article a link is not provided.
Medicaid HMOs and Perinatal Care
text document that has a comparative analysis of perinatal outcomes for mothers and newborns in a Chicago HMO. The focus is directed at the Medicaid population as compared to the general population of Chicago. The differences among the groups were minimal and not statisically significant. This is essentially a single-web document/report on this study. It is somewhat large (60K) and difficult to read as a web document. Its practicality is somewhat lost due to its size and the tables may not fit very well on small monitors. The informational content, however, is excellent and is useful for Medcaid managed care information. I thought it would be important to at least include some research documentation into this folder as well.
MEDICAID REFORM
This document is very lengthy and gives a general overview of the Medicaid program - both positive and negative. There are many useful tables and the document is very easy to read despite its large size. Various hyperlinks allow the reader to skip to the section of the document that he/she wants to read if they are not inclined to read the entire document. Medicaid managed care, incidentally, is located under the heading "What is Wrong with Medicaid?" Managed care is not shown very favorably in this document. The information provided is quite useful though. Links take the reader to the document's bibliography where additional sources of information (not on the Web) may be found.
MS Medicaid and Managed Care
This document is quite interesting in that is shows the initial entry of a state government into the managed care market. The intended audience of this document are managed care organizations that are interested in contracting with Mississippi for Medicaid managed care contracts. The document contains the guidelines and expectations of the state's solicitation for a MCO. The site is not entirely useful in understanding Medicaid and managed care, but it does have some interesting insights into the process. A potential downside to loading this document is the fact that it is in Acrobat PDF format. To view this document your server must have an Acrobat reader.
Prevention and Managed Care
Medscape document, "Prevention and Managed Care: Opportunities for MCO's, Purchasers of Health Care, and Public Health Agencies". Very informative article that is directly related to Medicaid managed care and the whole concept of prevention issues. The title of the article clearly outlines who the intended audience is as well. This document was put out by the CDC as their guidelines regarding prevention and managed care. A potential problem accessing this document will occur if you have not already registered for Medscape.

Sites

Hurting Real People
This site primarily has Medicaid information, albeit in an editorial-type context. The articles are very interesting and provide a lot of useful information. One specific document included examines the protection of Medicaid recipients from the influx of managed care into Medicaid marketplace. Included are many useful graphs and tables, but if your server is slow it may take some time for the transfer.
Medscape
Very large medical information site. Primary audience is health professionals, but some of the articles included are consumer related. The site provides inumerable links to documents, articles, and other areas of interest. It is clearly organized and divided into various groupings of medical interest. Medicaid and managed care documents are easily accessed through the menu. One minor drawback regarding this site is the fact that at one-time registration is required to read articles. It does not cost anything and subsribers receive email notification of upcoming articles and news.
Resource Guide: Glossary of Terms
This site is a glossary of managed care terminology, including Medicaid mention. The target audience is obviously someone not entirely familiar with managed care concepts, in that, the site is very basic. I might suspect, however, that someone seeking basic managed care information would find it useful. It is clearly organized and requires no further use because no further links are provided.
Texas Medicaid Reform Web Server
This site is very useful in investigating some specific state information regarding Medicaid managed care. The site is not spectacular graphically, but contains useful information nontheless. Users are even able to download the Texas Medicaid waiver directly from this site if they would like to further examine the waiver process.
The Health Policy Page from IDEA CENTRAL
Health policy page edited by Paul Starr. There are many interesting articles on a variety of medical topics. One of the focuses on this site is the question over Medicaid reform. Several small articles are within the site and further links are provided for additional information. As with most of the other sites, the primary target audience here seems to be the general public. The editor is obviously attempting to have his opinions reach a wide audience.

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