How Does Medicaid Managed Care Affect Provider Behavior? New Evidence from Spillovers on Private Health Care

How Does Medicaid Managed Care Affect Provider Behavior? New Evidence from Spillovers on Private Health Care PDF Author: Ajin Lee
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Medicaid is increasingly provided by private managed care plans. I investigate the staggered rollout of mandates across counties in New York, which required Medicaid beneficiaries to enroll in a private managed care plan. I find improvements following the mandate, as evidenced by increased routine office visits and child immunizations for Medicaid beneficiaries. Routine office visits similarly increased for the privately insured, especially in low-income areas, suggesting that physicians updated their overall practice styles when the mandate affected a large share of their patients. The same-signed spillover suggests that managed care directly shifted provider practice styles instead of simply sorting patients toward certain providers. Consistent with this result, I show that managed care expanded Medicaid beneficiaries' access to physicians and reduced market concentration relative to the public system.

How Does Medicaid Managed Care Affect Provider Behavior? New Evidence from Spillovers on Private Health Care

How Does Medicaid Managed Care Affect Provider Behavior? New Evidence from Spillovers on Private Health Care PDF Author: Ajin Lee
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Medicaid is increasingly provided by private managed care plans. I investigate the staggered rollout of mandates across counties in New York, which required Medicaid beneficiaries to enroll in a private managed care plan. I find improvements following the mandate, as evidenced by increased routine office visits and child immunizations for Medicaid beneficiaries. Routine office visits similarly increased for the privately insured, especially in low-income areas, suggesting that physicians updated their overall practice styles when the mandate affected a large share of their patients. The same-signed spillover suggests that managed care directly shifted provider practice styles instead of simply sorting patients toward certain providers. Consistent with this result, I show that managed care expanded Medicaid beneficiaries' access to physicians and reduced market concentration relative to the public system.

Medicaid Managed Care

Medicaid Managed Care PDF Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Managed care plans (Medical care)
Languages : en
Pages : 44

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Book Description


Spillover Theory

Spillover Theory PDF Author: Robert Tyler Braun
Publisher:
ISBN:
Category :
Languages : en
Pages : 82

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Book Description
Objective: To examine spillovers from a federal policy, managed care market, and community perspective. Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project's (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CM. S. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE). Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were used to examine a federal policy spillover on hospital readmissions. We used OLS and instrumental variable (IV) estimation to examined Medicare Advantage (MA) spillovers on Medicare fee-for-service (FFS) hospital readmissions. We used logistic regression to examine community uninsurance spillovers on the privately insured. Principal Findings: After the HRRP, Medicare FFS saw a decrease in 30-day preventable condition- and all-cause readmissions. Medicare Advantage saw a positive spillover after the HRRP. MA market penetration has no effect on Medicare FFS hospital readmissions. High community uninsurance rates are associated with less access to behavioral health related outpatient/office-based and prescription utilization. Conclusions: HRRP had a positive spillover on MA hospital all-cause readmissions. MA market penetration has no effect on Medicare FFS readmissions. High levels of community uninsurance are associated with poorer access to outpatient/office-based and prescription behavioral related services.

Integrating Behavioral Health Into Medicaid Managed Care

Integrating Behavioral Health Into Medicaid Managed Care PDF Author: Michelle Herman Soper
Publisher:
ISBN:
Category :
Languages : en
Pages : 13

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Book Description
Medicaid enrollees with behavioral health needs have a high prevalence of chronic conditions and are often frequent users of physical and behavioral health services. This brief provides insights from Medicaid officials and health plan representatives in five states -- Arizona, Florida, Kansas, New York and Texas -- that are pursuing innovative approaches to integrate behavioral health services within a comprehensive managed care arrangement. It explores key lessons to guide state integration efforts designed to improve outcomes and reduce costs.

Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population

Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population PDF Author: Laurence C. Baker
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
Concerns about the health of poor children and mothers produced major changes in the Medicaid public insurance program during the last decade, including expansions in program eligibility and increases in fees paid to physicians who care for covered patients. We examine physician responses to Medicaid policy changes aimed at improving care for pregnant women in order to understand the effects of Medicaid policy on physician behavior as well as to study the effectiveness of the expansions in improving access to care. While most previous studies have relied on data on physicians in private offices at a single point in time, we use repeated cross sections of data on young primary care physicians in a variety of practice settings. We find that expanded eligibility for Medicaid did increase access to physician services. However, contrary to the findings of some previous studies, increases in access are only apparent for the physicians in "public" institutions such as public clinics and hospital clinics; we find no evidence that increases in eligibility increase access to the physicians in our sample who are based in private offices. Our evidence also suggests that the impact of fees on physician behavior may be smaller than previous estimates would imply. We find that increases in fees are associated with increases in service to poor populations by these young private physicians, but some of this increase simply reflects shifting of patients from "public" sites to private physician offices.

Handbook of Health Economics

Handbook of Health Economics PDF Author: Mark V. Pauly
Publisher: Elsevier
ISBN: 0444535926
Category : Business & Economics
Languages : en
Pages : 1149

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Book Description
"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].

Report to the Congress, Medicare Payment Policy

Report to the Congress, Medicare Payment Policy PDF Author: Medicare Payment Advisory Commission (U.S.)
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 184

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Book Description


The Economics of Physician and Patient Behavior

The Economics of Physician and Patient Behavior PDF Author:
Publisher:
ISBN:
Category : Medical economics
Languages : en
Pages : 0

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Book Description


Investing in the Health and Well-Being of Young Adults

Investing in the Health and Well-Being of Young Adults PDF Author: National Research Council
Publisher: National Academies Press
ISBN: 0309309980
Category : Medical
Languages : en
Pages : 431

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Book Description
Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.

World Development Report 1978

World Development Report 1978 PDF Author:
Publisher: World Bank Publications
ISBN: 0821372823
Category : Adaptation (Biology)
Languages : en
Pages : 135

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Book Description
This first report deals with some of the major development issues confronting the developing countries and explores the relationship of the major trends in the international economy to them. It is designed to help clarify some of the linkages between the international economy and domestic strategies in the developing countries against the background of growing interdependence and increasing complexity in the world economy. It assesses the prospects for progress in accelerating growth and alleviating poverty, and identifies some of the major policy issues which will affect these prospects.