An Evaluation of Utah??s Primary Care Case Management Program for Medicaid Recipients
Bibliographic Data
| ID | 9100057 |
|---|---|
| Authors | Stephen H Long (Syracuse University, corresponding author), Russell F Settle (University of Delaware) |
| Year | 1988 |
| Volume | 26 |
| Issue | 11 |
| Pages | 1021-1032 |
| Publication date | 1988-11-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-198811000-00001 |
| PMID | 3054352 |
| OpenAlex | W1980274650 |
| Language | EN |
| Citations received | 6 |
| References cited | 1 |
One of the first case management (CM) programs for limiting Medicaid enrollees' freedom of choice of provider was established by Utah. By assigning enrollees to specific providers responsible for arranging all nonemergency care, Utah intended both to improve access and to reduce program costs. State officials expected the program to increase recipients' use of primary-care providers, while reducing their use of specialists, prescription drugs, and hospital outpatient services. Savings from reductions in unnecessary use were expected to more than offset increases in outlays arising from access enhancements, resulting in lower program expenditures. This study investigated the extent to which the state Medicaid program achieved these goals. The analysis was based on a two-part multivariate model of usage, estimated from data created from claims-level information provided by Utah. The findings revealed that the use of primary-care physician services increased significantly. However, the program also raised the use of specialists' services and prescription drugs. In contrast, the use of hospital outpatient services was lowered. Overall, CM apparently achieved the objective of increased access, but failed to attain the cost-containment goal. The findings indicated that expected costs for ambulatory care rose by 25% in the early years as a result of case management
Ambulatory · Ambulatory care · Business · Case management · Family medicine · Health care · Limiting · Managed care · Medicaid · Medical emergency · Medical prescription · Primary care · Utilization management · Healthcare Policy and Management · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes
Comparison of Access and Costs of Medicaid Dental Services in a Hospital Clinic and Community Practices
The Financial Implications of Availability and Quality of a Usual Source of Care for Children with Special Health Care Needs
Economic efficiency of gatekeeping compared with fee for service plans
Primary care case management and birth outcomes in the Iowa Medicaid program
Medicaid prenatal care
Medicaid Health Maintenance Organizations
| Unique citing works | 6 |
|---|---|
| Citations per year | 0.18 |
| Citation span | 1992 - 2007 (16) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 6 |