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Article
A Tale of Two Cities? The Heterogeneous Impact of Medicaid Managed Care
Journal of Health Economics (2014)
  • James Marton, Georgia State University
  • Aaron Yelowitz, University of Kentucky
  • Jeffrey Talbert, University of Kentucky
Abstract

Evaluating Accountable Care Organizations is difficult because there is a great deal of heterogeneity in terms of their reimbursement incentives and other programmatic features. We examine how variation in reimbursement incentives and administration among two Medicaid managed care plans impacts utilization and spending. We use a quasi-experimental approach exploiting the timing and county-specific implementation of Medicaid managed care mandates in two contiguous regions of Kentucky. We find large differences in the relative success of each plan in reducing utilization and spending that are likely driven by important differences in plan design. The plan that capitated primary care physicians and contracted out many administrative responsibilities to an experienced managed care organization achieved significant reductions in outpatient and professional utilization. The plan that opted for a fee-for-service reimbursement scheme with a group withhold and handled administration internally saw a much more modest reduction in outpatient utilization and an increase in professional utilization.

Publication Date
July 1, 2014
Citation Information
James Marton, Aaron Yelowitz and Jeffrey Talbert. "A Tale of Two Cities? The Heterogeneous Impact of Medicaid Managed Care" Journal of Health Economics Vol. 36 (2014)
Available at: http://works.bepress.com/yelowitz/16/