The Monterey County Health Initiative

Twenty months after the California State Department of Health Services turned its Medicaid program in Monterey County over to a local health care authority, the Monterey County Health Initiative (MCHI), the state terminated the pilot project in favor of a return to fee-for-service reimbursement. The MCHI, plagued from its inception with shaky provider support and a flawed program design, failed to demonstrate its anticipated cost savings. The key features of this failure were overly generous fees for primary case managers, inadequate utilization control measures, a general hesitancy to assume the necessary gatekeeper function, and a management information system that was not fully operational until well into the implementation of the program. Policy implications and recommendations for future state-sponsored Medicaid demonstration projects are discussed

Business · Control (management) · Economic growth · Economics · Health care · Management · Medicaid · Political science · Reimbursement · Service (business) · State (computer science) · Environmental Justice and Health Disparities · Marketing · Public Administration · Public Health Policies and Education

• A Typology of Medicaid Managed Care

  Robert E Hurley, Deborah A Freund•Medical Care•1988

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• Comparison of Access and Costs of Medicaid Dental Services in a Hospital Clinic and Community Practices

  Open Access•Millicent Marcus, Marvin Marcus et al.•Journal of Public Health Dentistry•1996

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• Emergency room use and primary care case management

  R E Hurley, R Hurley et al.•American Journal of Public Health•1989

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• Medicaid Health Maintenance Organizations

  Joan L Buchanan, Arleen Leibowitz et al.•Medical Care•1996

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