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Public managed care models and cost containment: The case of Medi -Cal.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Public managed care models and cost containment: The case of Medi -Cal./
作者:	Sheu, Mei-ling.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2001,
面頁冊數:	150 p.
附註:	Source: Dissertations Abstracts International, Volume: 63-05, Section: B.
Contained By:	Dissertations Abstracts International63-05B.
標題:	Health care expenditures. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3019802
ISBN:	9780493310268

Public managed care models and cost containment: The case of Medi -Cal.
Sheu, Mei-ling.

Public managed care models and cost containment: The case of Medi -Cal. - Ann Arbor : ProQuest Dissertations & Theses, 2001 - 150 p.

Source: Dissertations Abstracts International, Volume: 63-05, Section: B.

Thesis (Ph.D.)--University of California, Berkeley, 2001.

This item must not be sold to any third party vendors.

As a means to control costs and improve access, state governments began to enroll Medicaid beneficiaries in managed care plans in the 1990s. In California, the Medi-Cal program has enrolled a population of its Medicaid beneficiaries into three types of managed care programs: (1) the County Organized Health System (COHS); (2) the Geographic Managed Care (GMC); and (3) the Two-plan Model. The main objective of this study is to determine whether the implementation of managed care programs has resulted in lower medical care costs. With annual county data from 1990 to 1999, fixed effects models are used for the statistical analysis. Results indicate that a higher percentage of managed care enrollees is not associated with a lower average medical expenditure per beneficiary. Further analysis suggests that the average expenditure in counties having the COHS model was higher after the program started, while the average expenditure in counties with the GMC and Two-plan models were not statistically different from that of the comparison counties. However, some statistical models also suggest that while the average expenditure is higher when managed care is initially implemented, the growth rate decreases over time. The first explanation for this finding is that Medi-Cal's low fee-for-service rates have constrained the capacity for further cost reduction. Second, mandatory enrollment for only the relatively healthy population in the GMC and Two-plan Models has created biases which may have minimized the impact of managed care programs on overall health care costs. Third, the bargaining power of the COHS, the relatively small size of covered population and unspecified factors such as the beneficiary mix might have contributed to its higher level of average expenditure. The results of this study imply that cost containment is not an easy task for public managed care programs because it depends on multiple factors. In addition, it is important to monitor managed care performance so that quality of care is not compromised.

ISBN: 9780493310268Subjects--Topical Terms:

3433801
Health care expenditures.
Subjects--Index Terms:

Cost containment

Public managed care models and cost containment: The case of Medi -Cal.
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520 $a As a means to control costs and improve access, state governments began to enroll Medicaid beneficiaries in managed care plans in the 1990s. In California, the Medi-Cal program has enrolled a population of its Medicaid beneficiaries into three types of managed care programs: (1) the County Organized Health System (COHS); (2) the Geographic Managed Care (GMC); and (3) the Two-plan Model. The main objective of this study is to determine whether the implementation of managed care programs has resulted in lower medical care costs. With annual county data from 1990 to 1999, fixed effects models are used for the statistical analysis. Results indicate that a higher percentage of managed care enrollees is not associated with a lower average medical expenditure per beneficiary. Further analysis suggests that the average expenditure in counties having the COHS model was higher after the program started, while the average expenditure in counties with the GMC and Two-plan models were not statistically different from that of the comparison counties. However, some statistical models also suggest that while the average expenditure is higher when managed care is initially implemented, the growth rate decreases over time. The first explanation for this finding is that Medi-Cal's low fee-for-service rates have constrained the capacity for further cost reduction. Second, mandatory enrollment for only the relatively healthy population in the GMC and Two-plan Models has created biases which may have minimized the impact of managed care programs on overall health care costs. Third, the bargaining power of the COHS, the relatively small size of covered population and unspecified factors such as the beneficiary mix might have contributed to its higher level of average expenditure. The results of this study imply that cost containment is not an easy task for public managed care programs because it depends on multiple factors. In addition, it is important to monitor managed care performance so that quality of care is not compromised.
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