Impact of Medicaid Managed Care on Access to Care and Service Use

What impact do the different types of Medicaid managed care (MMC) configurations have on access to care and use of health care services by Medicaid beneficiaries? Researchers at the Urban Institute have analyzed data from the nationally representative National Survey of America’s Families Round 1 (data for 1997). They have also conducted a special follow-up survey of states that collected detailed information on their approaches to Medicaid managed care and the capitation rates they pay at the state and county levels. The investigators compared the characteristics of nonelderly Medicaid beneficiaries enrolled in MMC programs relative to those in fee-for-service Medicaid, and examine outcomes related to access and utilization of services, controlling for other factors. They also developed a model that attempts to correct for selection bias into managed care programs. Finally, they used National Survey of America’s Families Round 2 (data for 1999) data to examine changes in access and utilization for Medicaid beneficiaries between 1997 and 1999. The study examined whether Medicaid managed care programs have improved, or impeded, access to care for a national sample of Medicaid beneficiaries.