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Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates

J. Pol. Anal. Manage

Bibliographic Data

ID11684334
AuthorsMark Duggan (0000-0001-5251-0131, University of Pennsylvania, corresponding author), Tamara Hayford (0000-0002-0404-8744)
Year2013
Volume32
Issue3
Pages505-535
Publication date2013-03-21
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Policy Analysis and Management (JOURNAL)
Journal identifiersISSN: 0276-8739 • E-ISSN: 1520-6688
PublisherWiley (PUBLISHER • GB)
DOI10.1002/pam.21693
PMID23814802
OpenAlexW1942890642
LanguageEN
Citations received11
References cited28

From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from fee-for-service into managed care would lead to an increase or a reduction in Medicaid spending. This paper investigates this effect using a data set on state- and local-level MMC mandates and detailed data from the Centers for Medicare and Medicaid Services (CMS) on state Medicaid expenditures. The findings suggest that shifting Medicaid recipients from fee-for-service into MMC did not on average reduce Medicaid spending. If anything, our results suggest that the shift to MMC increased Medicaid spending and that this effect was especially present for risk-based HMOs. However, the effects of the shift to MMC on Medicaid spending varied significantly across states as a function of the generosity of the state's baseline Medicaid provider reimbursement rates

Actuarial science · Business · Demographic economics · Economic growth · Economics · Generosity · Health care · Managed care · Medicaid · Medicaid managed care · Political science · Reimbursement · Service (business · Global Health Care Issues · Healthcare Policy and Management · Law · Medicine · Primary Care and Health Outcomes · Marketing

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Unique citing works11
Citations per year1
Citation span2015 - 2024 (10)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 11
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