Medicaid Managed Care

Medicaid is often thought of as the program for low-income women and children. In researching this topic, I discovered that by 1995 Medicaid covered approximately 10% of Americans. It is true that low-income families make up almost 75% of Medicaid beneficiaries, however they account for only 28% of the spending. Medicaid also serves as health insurance for the elderly, blind and disabled. The elderly and disabled account for approximately 60% of all Medicaid dollars.

Approximately 40% of the Medicaid population, mostly women and children, are now enrolled in managed care. The percentage is increasing as managed care is being mandated for more Medicaid populations. Many special interest groups have concerns and opinions about how managed care will affect the populations that they represent. They include, among others, groups representing the homeless, children with special needs, persons with disabilities, and the Indian Health Service.

Listed below are several web pages and documents that deal with Medicaid managed care or concerns about a population affected by it.
 
 

Web Sites



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This site has links to many articles and sites that cover a variety of healthcare issues including Medicaid managed care.

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Murphy's Unofficial Medicaid Page: A Resource Guide to Medicaid - America's Medical Assistance Program is an excellent source of information about this issue. I would have listed it first because it truly does have a wealth of information, however as a geocities site it also has an annoying advertisement that you have to contend with.

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This is the Center for Health Care Strategies, Inc. home page. It is harder to navigate through, although it does contain a lot of information. Many of the documents that this site has links to are for sale.

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This is the Health Care Financing Administrations Medicaid page. It contains a lot of technical information. The site lists 120 documents under the listing of Medicaid managed care in its search wizard.

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The National Academy for State Health Policy site listed documents that I did not find in other places including a report on Medicaid Managed Care and Native Americans, and one on Dental Care in Medicaid Managed Care. Unfortunately they could not be downloaded, they had to be ordered (read that - for sale).

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This is the web site for the American Academy of Pediatrics. It is naturally limited in scope to children and children with special needs.

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I am not sure whose site this is. It has limited information and very limited links.
 
 

Documents

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Medicaid Managed Care: The Challenge of Providing Care to Low-Income Women - is from the Jocobs Institute of Women's Health (I was not aware of this organization). This article looks at Medicaid managed care from the perspective of low-income women, with an emphasis on reproductive health care.

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Searching for the Right Fit: Homelessness and Medicaid Managed Care Care for the Homeless, NYC in collaboration with the National Health Care for the Homeless Council. I found this site hard to scroll, but the information is unique. I had never thought about how homeless people accessed health care, I guess I assumed that they were taken care of by charity care. This document had very good information about the special needs of this population.

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Medicaid Managed Care for Persons with Disabilities. This article included background information about persons with disabilities, what types of options are being offered, and some of the potential problems of providing services through a managed care system.

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The American Academy of Pediatrics Policy Statement on Managed Care and Children with Special Health Care Needs: A Subject Review (RE9814) from the Committee on Children with Disabilities. This includes the concerns and suggestions from the AAP.

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Criteria for Evaluating Proposed Changes in Medicaid. The American Public Health Association put together a paper to provide public health advocates with criteria that can be used during policy debates, very clear and concise.

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Meeting the Challenge of Serving People With Disabilities: A Resource Guide for Assessing the Performance of Managed Care Organizations. This huge (65 page) document from the Center for Health Outcomes Improvement Research, Center for Health Policy Research, is a very comprehensive way to measure care for people with disabilities in a managed care setting.

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A Guide to Marketing and Enrollment in Managed Care. This document includes case studies concerning problems with some of the marketing efforts by Medicaid managed care organizations.

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New Directions for Mental Health Services. A very brief overview of the problems and potential benefits of Medicaid managed care for behavioral health care services.

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Arc's Managed Care & Medicaid Fact Sheet. Just a quick overview of Medicaid managed care for people with developmental disabilities.

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H.M.O.'s Are Cutting Back Coverage of the Poor and Elderly. I am not sure if this is an actual NY Times article or if the New York Times on the Web has its own unique articles.

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A very brief article, short on facts, big on drama.

Note: The information below may contain additional relevant materials and documents. Some of the information may be duplicate. The evaluations depend on both the student doing the review and the information contained at the time of the review. Sites are subject to change!