The authors use variation across states and over time in managed care (MC) programs for publicly insured children to examine whether effects differ for children with chronic health conditions (CWCHC) and those without. The authors pool data from the 1997 to 2002 National Health Interview Survey and link county, year, and health status information on type of MC programs implemented. Findings show that the effects of MC are concentrated on CWCHC and that CWCHC experience reductions in use of specialist, mental health, and prescription drugs. Capitated programs with mental health or specialty carve-outs are associated with a greater number and larger decreases in service use compared to integrated capitated programs. While it is not possible to determine whether MC programs resulted in more appropriate use of services, corresponding reductions in perceived access were not observed, suggesting that net effects of MC on service use represent improvements in care coordination.
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Busch, A.B., Frank, R.G., & Lehman, A.F. (2004). The effect of a managed behavioral health carve-out on quality of care for Medicaid patients diagnosed as having schizophrenia . Archives of General Psychiatry, 61(5), 442-448.
5.
Centers for Medicare and Medicaid Services. ( 1997-2002). Medicaid managed care enrollment report (1997-2002). Retrieved June 1, 2004, from http://www.cms.hhs.gov/medicaid/mcaidsad.asp
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Centers for Medicare and Medicaid Services. ( 2005). National summary of Medicaid managed care programs and enrollment. Retrieved January, 25, 2006, from http://www.new.cms.hhs.gov/MedicaidDataSourcesGenInfo/Downloads/mmcpr03.pdf
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Davidoff, A. (2004). Insurance for children with special health care needs: Patterns of coverage and burden on families to provide adequate insurance . Pediatrics, 114, 394-403.
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Davidoff, A., Hill, I., Courtot, B., & Adams, E. (2007). Effects of managed care on service use and access for children with chronic health conditions. Pediatrics, 119, 956-964.
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Davidoff, A., Yemane, A., & Hill, I. (2004). Public insurance eligibility and enrollment for special healthcare needs children. Health Care Financing Review , 26(1), 119-135.
11.
Fox, H.B., McManus, M.A., Almeida, R.A., & Lesser, C. (1997). Medicaid managed care policies affecting children with disabilities: 1995 and 1996. Health Care Financing Review , 18(4), 23-36.
12.
Garrett, B., Davidoff, A.J., & Yemane, A. (2003). Effects of Medicaid managed care programs on health services access and use. Health Services Research, 38(2), 575-594.
13.
Garrett, B., & Zuckerman, S. (2005). National estimates of the effects of mandatory Medicaid managed care programs on health care access and use, 1997-1999. Medical Care, 43(7), 649-657.
14.
Hill, I. (2000). Charting new courses for children's health insurance . Policy and Practice, 58(4), 30-38.
15.
Hill, I., Hawkes, C., & Harrington, M. (2003). Final cross-cutting report on the findings from ten state site visits. Princeton, NJ: Mathematica Policy Research.
16.
Hill, I., Schwalberg, R., Zimmerman, B., Tilson, W., & Ireys, H. (2002). Achieving service integration for children with special health care needs: An assessment of alternative Medicaid managed care models. Journal of Health Care Policy and Law, 5(1), 208-232.
17.
Holahan, J., & Suzuki, S. (2003). Medicaid managed care payment methods and capitation rates in 2001. Health Affairs, 22(1), 204-218.
18.
Hurley, R., Freund, D., & Paul, J. (1993). Managed care in Medicaid: Lessons for policy design . Ann Arbor, MI: Health Administration Press.
19.
Kenesson, M. (1998). Medicaid managed care: Outreach and enrollment for special populations (Working paper). Hamilton, NJ: Center for Health Care Strategies.
20.
Liu, C.F., Manning, W.G., Christianson, J.B., Stoner, T., Lurie, N., Gray, D.Z., et al. (1999). Patterns of outpatient use of mental health services for Medicaid beneficiaries under a prepaid mental health carve-out . Administration and Policy in Mental Health, 26(6), 401-415.
21.
National Academy for State Health Policy. (n.d.). Medicaid managed care: A guide for the states (3rd, 4th, and 5th eds.). Portland, ME: National Academy for State Health Policy.
22.
Newacheck, P.W., McManus, M., Fox, H.B., & Hung, H.N. (2000). Access to health care for children with special health care needs. Pediatrics, 105(4, Pt. 1), 760-766.
23.
Newacheck, P.W., Stein, R.E., Walker, D.K., Gortmaker, S.L., Kuhlthau, K., & Perrin, J.M. (1996). Monitoring and evaluating managed care for children with chronic illnesses and disabilities. Pediatrics, 98(5), 952-958.
24.
Rowland, D., Rosenbaum, S., Simon, L., & Chair, E. (1995). Medicaid and managed care: Lessons from the literature. A Report of the Kaiser Commission on the Future of Medicaid. Menlo Park, CA: Kaiser Family Foundation.
25.
Szilagyi, P.G. (1998). Managed care for children: Effect on access to care and utilization of health services. Future Child, 8(2), 39-59.
26.
Zuckerman, S., Brennan, N., & Yemane, A. (2002). Medicaid managed care and beneficiary access and use. Inquiry, 39(3), 221-242.
