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Health Serv Res. 2001 April; 36(1 Pt 1): 7–23.
PMCID: PMC1089213

Impacts of Medicaid managed care on children.


OBJECTIVE: To assess the impact of switching from a fee-for-service (FFS) delivery system to managed care on access to, use of, and satisfaction with health care for children. DATA SOURCES/STUDY SETTING: A 1998 survey of Medicaid recipients in rural Minnesota. STUDY DESIGN: Using a quasi-experimental framework, we compare the experiences of children on Medicaid living in counties that had switched to managed care with those of children living in counties operating under FFS Medicaid. We address the impact of Medicaid managed care (MMC) on access to, use of, and satisfaction with care. DATA COLLECTION METHODS: A stratified random sample of children on Medicaid was drawn based on Medicaid enrollment files. Telephone interviews were conducted with the child's parent or guardian between March and June 1998. An overall response rate of 70 percent was achieved, yielding a sample of 1,106 children (814 in MMC and 792 in Medicaid FFS). PRINCIPAL FINDINGS: We find very few significant differences in access to, use of, or satisfaction with health care services for children under MMC relative to FFS. MMC did not change the patterns of health care service use or the location at which care is delivered, two major goals of MMC initiatives. CONCLUSIONS: Our results suggest that the Medicaid program's shift from FFS to managed care had little impact on the pattern of children's health care use, the location at which they obtained care, or the satisfaction with the care they received.

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Selected References

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  • Abrams R, Savela T, Trinity MT, Falik M, Tutunjian B, Ulmer C. Performance of community health centers under managed care. J Ambul Care Manage. 1995 Jul;18(3):77–88. [PubMed]
  • Andersen R, Aday LA. Access to medical care in the U.S.: realized and potential. Med Care. 1978 Jul;16(7):533–546. [PubMed]
  • Coughlin TA, Long SK. Effects of medicaid managed care on adults. Med Care. 2000 Apr;38(4):433–446. [PubMed]
  • Deal LW, Shiono PH, Behrman RE. Children and managed health care: analysis and recommendations. Future Child. 1998 Summer-Fall;8(2):4–24. [PubMed]
  • Felt-Lisk S, Silberman P, Hoag S, Slifkin R. Medicaid managed care in rural areas: a ten-state follow-up study. Health Aff (Millwood) 1999 Mar-Apr;18(2):238–245. [PubMed]
  • Freund DA, Rossiter LF, Fox PD, Meyer JA, Hurley RE, Carey TS, Paul JE. Evaluation of the Medicaid competition demonstrations. Health Care Financ Rev. 1989 Winter;11(2):81–97. [PubMed]
  • Heinen L, Fox PD, Anderson MD. Findings from the Medicaid Competition Demonstrations: a guide for states. Health Care Financ Rev. 1990 Summer;11(4):55–67. [PubMed]
  • Hudson T. Rural priorities. Hospital links and managed care contracts top the list. Hosp Health Netw. 1995 Feb 20;69(4):40–44. [PubMed]
  • Hughes DC, Luft HS. Managed care and children: an overview. Future Child. 1998 Summer-Fall;8(2):25–38. [PubMed]
  • Mauldon J, Leibowitz A, Buchanan JL, Damberg C, McGuigan KA. Rationing or rationalizing children's medical care: comparison of a Medicaid HMO with fee-for-service care. Am J Public Health. 1994 Jun;84(6):899–904. [PubMed]
  • Oleske DM, Branca ML, Schmidt JB, Ferguson R, Linn ES. A comparison of capitated and fee-for-service Medicaid reimbursement methods on pregnancy outcomes. Health Serv Res. 1998 Apr;33(1):55–73. [PMC free article] [PubMed]

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