Medicaid Managed Care Bibliography

2017

Timothy Layton et al. Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition. National Bureau of Economic Research. June 2017.

Health Affairs. Medicaid And Marketplace Eligibility Changes Will Occur Often In All States; Policy Options Can Ease Impact. June 2017.

Health Affairs. Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful For Many. June 2017.

Moving Healthcare Upstream. Pathways through Medicaid to Prevention. March 2017.

Polsky D, et al .ACA does not worsen primary care shortage for Medicaid, private coverage patients. JAMA Intern Med. February 28, 2017.

Ohio Association of Health Plans. The Impact of Private Industry on Public Health Care: How Managed Care is Reshaping Medicaid in Ohio. January 2017.

2016

Sommers, Benjamin et al. Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful for Many October 2016.

Sommers, Benjamin D. et al. Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance. August 2016

Jeffrey H. Silber et. al. Practice Patterns in Medicaid and Non-Medicaid Asthma Admissions. Pediatrics. July 6, 2016.

Anthem Public Policy Institute. Healthy Indiana Plan 2.0: Enhanced Consumer Engagement and Decision-Making are Driving Better Health July 2016

Oliver Wyman. Right Place, Right Time: Marketplace Perspectives on Providing Health Information to Vulnerable Populations. June 2016

Cross-Call, J. Medicaid Expansion Producing State Savings and Connecting Vulnerable Groups to Care. June 2016

Health Management Associates. Changing Course: The Role of Health Plans in Curbing the Opioid Epidemic. June 2016.

Lori Uscher-Pines, Ph.D., et. al. Effect of Teledermatology on Access to Dermatology Care Among Medicaid Enrollees. JAMA Dermatol. May 2016.

Gottlieb LM et. al. Clinical interventions addressing nonmedical health determinants in Medicaid managed care. Am J Manag Care, May 2016. 22(5):370-6.

American Journal of Managed Care. Medicaid Managed Care Reduces Readmissions for Youths With Type 1 Diabetes. April 2016.

Hu, L., Kaestner, R., Mazumder, B. The Effect of the Patient Protection and Affordable Care Act Medicaid Expansions on Financial Well-Being. April 2016

Northeastern University. Population Health Investments by Health Plans and Large Provider Organizations. March 2016

National Alliance of State and Territorial Aids Directors. Financing HIV Prevention Services. February 2016.

The Menges Group. Assessment of Medicaid MCO Preferred Drug List Management Impacts. For the Texas Association of Health Plans. February 2016.

2015

Kaiser Family Foundation. Renewals in Medicaid and CHIP: Implementation of Streamlined ACA Policies and the Potential Role of Managed Care Plans. June 26, 2015

Blumenthal, David et al. Does Medicaid Make a Difference? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. The Commonwealth Fund, June 2015

Sellers Dorsey and Milliman. Medicaid Managed Care in Texas: A Review of Access to Services, Quality of Care, and Cost Effectiveness. February 2015.

Milliman. Texas Medicaid Managed Care Cost Impact Study. February 17, 2015.

Brown, D., Kowalski, A., Lurie, I. Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?. National Bureau of Economic Research, January 2015

2014

Sandberg, S. et. al. Hennepin Health: A Safety-Net Accountable Care Organization For The Expanded Medicaid Population. Health Affairs, November 2014. 33:111975-1984.

Ramsey, R. Health Resilience Specialists: The Key to Providing Quality Care to High-Risk Patients. Trust for America’s Health, November 2014.

Miller, S., Wherry, L. The Long-Term Health Effects of Early Life Medicaid Coverage. July 2014

2013

Felland L., Lechner A., Sommers A. Improving Access to Specialty Care for Medicaid Patients: Policy Issues and Options. Commonwealth Fund. June 2013.

PCG Health. Report on the Value of Minnesota Health Care Programs (MHCP) Managed Care, as Compared to Fee-For-Service. September 2013.

Mancini, Tara. Covering Parents is Good For Kids: Continuous Coverage is Even Better. Say Ahhh! A Children’s Health Policy Blog. July 2013.

Chen AH, Murphy EJ, Yee HF. eReferral: A New Model for Integrated Care. N Engl J Med 368;26. June, 2013.

Blumenthal, David et al. Does Medicaid Make a Difference? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. The Commonwealth Fund, June 2015

Coughlin T, Courtot B, Peters R. Are State Medicaid Managed Care Programs Ready for 2014? A Review of Eight States. Urban Institute/RWJF. May 2013.

Bird, Vivian. Assessing the Usability of MAX 2008 Encounter Data for Comprehensive Managed Care. MMRR. April 2013.

2012

ASPE Report by Urban Institute. Medicaid and CHIP Managed Care Payment Methods and Spending in 20 States. December 2012.

Katharine Weigert and Caroline Hess, NASHP and the Commonwealth Fund. Including Safety-Net Providers in Integrated Delivery Systems. August 2012.

Meyer, B., Wherry, L. Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility. August 2012

McCue, Mike. Financial Performance of Health Plans in Medicaid Managed Care. MMRR, July 2012.

ASPE Report by Urban Institute: Medicaid and CHIP Risk-Based Managed Care in 20 States: Experiences Over the Past Decade and Lessons for the Future. July 2012.

Maryland Health Choice Program

2011

Commonwealth Fund: Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues. October 2011.

Kaiser Commission on Medicaid and the Uninsured. A Profile of Medicaid Managed Care Programs in 2010: Findings From a 50-State Survey. September 2011.

Commonwealth Fund: Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care They Provide. September 2011.

Frakt, A., Carroll, A., Pollack, H., et al. Our Flawed but Beneficial Medicaid Program. The New England Journal of Medicine, April 2011.

Lewin Group. An Evaluation of Medicaid Savings from Pennsylvania’s HealthChoices Program. May 2011.

Sommers, B & Rosenbaum, R. Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges. Health Affairs. February 2011.

Minnesota Department of Human Services. Provider Payment and Reimbursement Rates, January 2011

2010

Ingenix Consulting. Health Benefit Exchange: Design Options for Safety Net Plans. November 2010.

Zelman, W. (State Coverage Initiative Project & Academy Health) Community-Based Nonprofit Medicaid Plans and the New Health Insurance Exchanges: Opportunities and Challenges. October 2010.

LaPar, D., Bhamidipati, C., Mery, C., et al. Primary Payer Status Affects Mortality for Majory Surgical Operations. Annals of Surgery, September 2010.

ACAP. How Safety Net Health Plans are Transforming Primary Care: Case Studies from the Field. August 3, 2010

The Commonwealth Fund. CareOregon: Transforming the Role of a Medicaid Health Plan from Payer to Partner. July 2010.

Texas Association of Business. Expanding Medicaid Managed Care in Texas: The Right Dosage For Texas Recipients. May 2010.

Volk, Gwyn and Jaconbs, Anne. Implementing State Health Reform: Lessons for Policymakers. March 2010.

Center for Health Care Strategies, Melanie Bella and Lindsay Palmer-Barnette. Options for Integrating Care for Duals. March 2010.

Kaiser Family Foundation. Medicaid and Managed Care: Key Data, Trends, and Issues. February 2010

Eberly, T., Davidoff, A., and Miller, C. Managing the Gap: Evaluating the Impact of Medicaid Managed Care on Preventive Care Receipt by Child and Adolescent Minority Populations. Journal of Health Care for the Poor and Underserved 21 (2010): 92-111.

Finuf, Bob. (Children’s Mercy FHP) Medicaid Managed Care & CMFHP: A Proven Record of Providing Value. January 4, 2010.

Finuf, Bob. (Children’s Mercy FHP) Comparison of Kansas & Oklahoma Medicaid Managed Care Market Conditions. January 4, 2010.

2009

United Hospital Fund. The Big Picture: Private and Public Health Insurance Markets in New York. Fall 2009.

Harman, J. & Duncan, P. (University of Florida) An Analysis of Medicaid Expenditures Before and After Implementation of Florida’s Medicaid Reform Pilot Demonstration. June 2009.

Kaiser Family Foundation. Survey of Healthy San Francisco Participants. August 2009.

Lewin Group, ACAP, and MHPA. Medicaid Non-Emergency Out-of-Network Payment Study. July 2009.

ACAP and The George Washington University. Improving Medicaid’s Continuity and Quality of Care. July 2009.

Coalition on New York State Public Health Plans, Medicaid Managed Care & Family Health Plus Quality Update. May 2009.

California Program for Access to Care, Understanding the Slow Growth in Medi-Cal and Healthy Families Premiums, 1999-2008. April 2009.

Lewin Group and AHIP, Medicaid Managed Care Cost Savings – A Synthese of 24 Studies. March 2009.

2008

Bindman A et al.: Interruptions in Medicaid Coverage and Risk for Hospitalization for Ambulatory Care Sensitive Conditions. Annals Int Med, 2008.

Bindman A et al.: Medicaid Re-Enrollment Policies and Children’s Risk of Hospitalizations for Ambulatory Care. Medical Care, 2008.

Lewin Group and ACAP, Analysis of Dual Eligible Pharmacy Costs Under Medicaid and Medicare Part D, September 2008.

Lewin Group and ACAP, Analysis of Drug Rebate Equalization Act’s Savings to the Medicaid Program, September 2008.

2007

Christopher Trenholm, Embry Howell, Ian Hill, and Dana Hughes, Three Independent Evaluations of Healthy Kids Programs Find Dramatic Gains in Well-Being of Children and Families. Mathematica In Brief #1; November 2007

Lewin Group and ACAP, Programmatic Assessment of Carve-In and Carve-Out Arrangements for Medicaid Prescription Drugs, October 24, 2007

Lewin Group and ACAP, Medicaid Health Plans: A Turnkey Solution for Expanding Health Insurance Coverage Case Studies of California and Massachusetts, July 2007

Cynthia R. Schuster, M.P.P., Jean M. Mitchell, Ph.D., and Darrell J. Gaskin, Ph.D., Partially Capitated Managed Care Versus FFS for Special Needs Children. Health Care Financing Review, Summer 2007,Volume 28, Number 4

Association for Community Affiliated Plans & National Association of Community Health Centers, The Impact of Community Health Centers & Community-Affiliated Health Plans on Emergency Department Use, April 2007.

Lewin Group with Association for Community Affiliated Plans and Medicaid Health Plans of America, Collaboration in Medicaid Managed Care Rate Setting, March 2007

Suzanne Felt-Lisk, M.P.A., Allison Barrett, and Rebecca Nyman, M.P.H., Public Reporting of Quality Information on Medicaid Health Plans. Spring 2007

Lewin Group, Assessment of HUSKY’s, Connecticut’s Medicaid Managed Care Program, January 17, 2007

2006

Roohan, Patrick J. , MS, Jacqueline M. Butch, MBA, Joseph P. Anarella, MPH, Quality Measurement in Medicaid Managed Care and Fee-for-Service: The New York State Experience. American Journal of Medical Quality, Volme 21, No 3, 185-191, December 2006.

Disability Care Coordination Organizations, The Experience of Medicaid Managed Care Programs for People with Disabilities. Center for Health Care Strategies, 2006

Lewin Group, Medicaid Capitation Expansion’s Potential Cost Savings, April 18, 2006

Association for Community Affiliated Plans, Safety Net Health Plans: Critical Partners in the Health Care Safety Net –April 2006

Elaine Batchlor, Creating a Win-Win-Win With P4P, January, 2006

Lewin Group, Rate Setting and Actuarial Soundness in Medicaid Managed Care, January 23, 2006

2005

Stephen Berman, Carl Armon, and James Todd, Impact of a Decline in Colorado Medicaid Managed Care Enrollment on Access and Quality of Preventive Primary Care Services PEDIATRICS December 1, 2005 Vol. 116 No. 6 December 2005, pp. 1474-1479

Schneider, Eric C., Alan M. Zaslavsky, Arnold M. Epstein, Quality of care in for-profit and not-for-profit health plans enrolling Medicare beneficiaries. The American Journal of Medicine, Volume 118, Issue 12, pages 1392-1400, December 2005

National Academy of State Health Policy Medicaid Managed Care: Looking Forward, Looking Back. June 2005

The Lewin Group, Comparative Evaluation of Pennsylvania’s HealthChoices Program and Fee-for-Service Program, May 2005

The Lewin Group, Assessment of Medicaid Managed Care Expansion Options in Illinois, May 2005

Xiao X, Jensen GA. Utilization of Health Care Services Among the Near-Elderly: A Comparison of Managed Care and Fee-for-Service Enrollees. Managed Care Interface, March 2005

Michigan Medicaid: Relative Cost Effectiveness of Alternative Service Delivery Models, University of Maryland, Center for Health Program Development and Management, April 2005

Ann S. O’Malley, Christopher B. Forrrest, Robert M. Politzer, John T. Wulu and Leiyu Shi. Health Center Trends, 1994-2001: What Do They Portend For The Federal Growth Initiative? Health Affairs, Volume 24, Number 2, March/April 2005, 465-472.

Stankaitis JA, Brill HR, and Walker DM. Reduction in Neonatal Intensive Care Unit Admission Rates in a Medicaid Managed Care Program. The American Journal of Managed Care. March 2005

Innovations in Medicaid Managed Care. Health Plan Programs to Improve the Health and Well-Being of Medicaid Beneficiaries. America’s Health Insurance Plans. March 2005

Mittler, J & Gold, M. Managed Care Quarterly. Physician Participation in Medicaid Managed Care: The California Experience. Vol. 13 Num. 2 Pgs 1-11. Spring 2005.

Chyongchiou Jeng Lin, Donald Musa; Myrna Silverman and Howard B. Degenholtz. Do Managed Care Plans Reduce Racial Disparities in Preventive Care? Journal of Health Care for the Poor and Underserved,February 2005

2004

James M. Guwani, Ph.D. and Robert Weech-Maldonado, M.B.A. Medicaid Managed Care and Racial Disparities in AIDS Treatment. Health Care Financing Review. Winter 2004-2005/Volume 26, Number 2, 119-132.

United States Government Accountability Office. Medicaid Managed Care: Access and Quality Requirements Specific to Low-Income and Other Special Needs Enrollees. Report to Senators, December 2004

Eric Schneider, Bruce Landon, Carol Tobias and Arnold M. Epstein. Quality Oversight in Medicaid Primary Care Case Management Programs: As HMOs depart, are state Medicaid agencies ready to take the stage. Health Affairs, Volume 23, December 2004

The Lewin Group. Business Opportunities in the Medicare Modernization Act for Medicaid Focused Plans, November 2004

Womeodu RJ, Graney MJ, Gibson DV, Bailey JE.Diabetic Patient Experiences in a Medicaid Managed Care System. Tennessee Medicine. 96(10): 465-9, Oct. 2004

Bruce E. Landon, Eric C. Schneider, Carol Tobias, and Arnold M. Epstein The Evolution Of Quality Management In Medicaid Managed Care. Health Affairs, July/August 2004; 23(4): 245-254

The Lewin Group. Medicaid Managed Care Cost Savings: A Synthesis of Fourteen Studies. Final Report Prepared for: America’s Health Insurance Plans, July 2004

Jean M. Mitchell, PhD, and Darrell J. Gaskin, PhD. Do Children Receiving Supplemental Security Income Who Are Enrolled in Medicaid Fare Better Under a Fee-for-Service or Comprehensive Capitation Model? Pediatrics 2004; 114: 196-204, July, 2004.

Verdier JM, Hurley RE. State Medicaid Managed Care Evaluations and Reports, Themes, Variations and Lessons. Resource Paper. Center for Health Care Strategies. May 2004

The National Association for State Health Policy, State Budget Cuts and Medicaid Managed Care: Case Studies in Four States, June 2004

Debra A. Draper, Robert E. Hurley, and Ashley C. Short Medicaid Managed Care: The Last Bastion Of The HMO? Health Affairs, March/April 2004; 23(2): 155-167.

Teresa A. Coughlin, Brian K. Bruen, and Jennifer King States: Use Of Medicaid UPL And DSH Financing Mechanisms Health Affairs, March/April 2004; 23(2): 245-257.

Andrew B. Bindman, Arpita Chattopadhyay, Dennis H. Osmond, William Huen, and Peter Bacchetti. The Impact of Medicaid Managed Care on Hospitalizations for Ambulatory Care Sensitive Conditions. Health Services Research, Feb 2004

2003

Manatt, Phelps & Phillips, LLP. Medicaid Managed Care in New York: A Public-Private Partnership That Works. A report of the New York State Coalition of Prepaid Health Services Plans. December 2003

Hurley, Robert and Michael McCue, Profiting from Proficiency: The Growing Importance of Medicaid-Focused Health Plans. Center for Health Care Strategies, November 2003

The Alliance of Community Health Plans (ACHP) and the Association for Community Affiliated Plans (ACAP). Promoting Disease Prevention in Health Plans: Information Systems and Technology Assessment, October 2003.

Shields AE, Comstock C, Finkelstein JA, and Weiss KB. Comparing Asthma Care Provided to Medicaid-Enrolled Children in a Primary Care Case Manager Plan and a Staff Model HMO. Ambulatory Pediatrics. Volume 3, Number 5. September- October 2003

Patrick J Roohan et al. Do Commercial Managed Care Members Rate Their Health Plans Differently than Medicaid Managed Care Members? Health Serv Res. 2003 Aug; 38(4): 1121–1134.

United States Government Accountability Office. Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened. June 2003

Robert E. Hurley. Medicaid-Focused Health Plans: A Community Health Conspiracy, June 2003

Debra A Draper and Marsha R Gold. Provider risk sharing in Medicaid managed care plans Health Affairs, May/June 2003; 22(3): 159-167

Smith V, Hamacher L. – The Good Olde Days of Fee-for-Service Were Not So Good After All: Managed Care Has Made Things Better. Health Management Associates for the Association of Health Center Affiliated Health Plans. May 2003

The Lewin Group. Extending the Federal Drug Rebate to Medicaid MCOs: Analysis of Impacts, May 2003

John Holahan and Shinobu Suzuki Medicaid managed care payment methods and capitation rates in 2001 Health Affairs, January/February 2003; 22(1): 204-218.

Marsha Gold, Jessica Mittler, Debra Draper, and David Rousseau Participation of plans and providers in Medicaid and SCHIP managed care. State Children’s Health Insurance Program Health Affairs, January/February 2003; 22(1): 230-240

Robert E Hurley and Stephen A Somers. Medicaid and managed care: a lasting relationship? Health Affairs, January/February 2003; 22(1): 77-88

Nancy Beronja, Joel Menges and Meg Murray. Comparison of Medicaid Pharmacy Costs and Usage between the Fee-for-Service and Capitated Settings, January 2003

Chang, Debbie, Alice Burton, John O’Brien, and Robert E. Hurley. Honesty As Good Policy: Evaluating Maryland’s Medicaid Managed Care Program. The Milbank Quarterly, Vol. 81, No. 3, 2003.

2002

Sparer, M., Brown, L., Gusmano, M., Rowe, C., and Gray, B. Promising Practices: How Leading Safety-Net Plans are Managing the Care of Medicaid Clients. Health Affairs. 21 No. 5 (2002): 284-291

American Journal of Public Health. Provision of Sexual Health Services to Adolescent Enrollees in Medicaid Managed Care. Vol 92, No. 11, Pgs. 1779-1783. November 2002

Schaller Anderson, Inc. Serving the Special Program/Aged, Blind, and Disabled Population through Managed Care. Center for Health Care Strategies, Inc. April 2002.

Barclay, Timothy. (Milliman) Wisconsin HMOs’ Success in Medicaid and BadgerCare: Government Cost Savings and Better Health Care Quality. February 22, 2002

2001

Suzanne Felt-Lisk, Rebecca Dodge, and Megan McHugh, Trends in Health Plans Serving Medicaid: 2000 The Henry J. Kaiser Family Foundation, November 2001, Document No. PR01-83, 44 Pages

2000

 

Sparer, M., and Brown, L. Uneasy alliances: managed care plans formed by safety-net providers. Health Affairs. 19 No. 4 (September/October 2000): 23-35

Bindman AB, Grumbach K, Bernheim S, Vranizan K, Cousineau M. Medicaid managed care’s impact on safety-net clinics in California. Health Aff (Millwood). 2000 Jan-Feb;19(1):194-202.

Gray, BH and Rowe, C. Safety-net health plans: a status report. Health Affairs. 19 No 1 (January/February 2000): 185-193

1999

American Journal of Public Health. “The effect of a Medicaid managed care program on the adequacy of prenatal care utilization in Rhode Island. Vol. 89, Issue 4 497-501. April 1999.