View Research by Author - Alison Evans

Citation URL: http://www.urban.org/AlisonEvans

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

This study examines the recent expansion of Medicaid managed care from the perspective of the thirteen states in the Urban Institute's Assessing the New Federalism project. States are moving to managed care for Medicaid both to improve beneficiaries' access and to control the growth in program costs. However, we find that despite dramatic growth in enrollment during this decade, few states are enrolling the elderly or the disabled--the most expensive Medicaid beneficiaries. We also conclude that cost-savings objectives are often at odds with goals of contracting with mainstream plans and protecting safety-net providers.

This study examines the recent expansion of Medicaid managed care from the perspective of the thirteen states in the Urban Institute’s Assessing the New Federalism project. States are moving to managed care for Medicaid both to improve beneficiaries’ access and to control the growth in program costs. This article finds that despite dramatic growth in enrollment during this decade, few states are enrolling the elderly or the disabled – the most expensive Medicaid beneficiaries. It also concludes that cost-savings objectives are often at odds with goals of contracting with mainstream plans and protecting safety-net providers. (Health Affairs 1998 May/June; 17(3):43-63)

Since 1982, Medicare has contracted with health maintenance organizations (HMOs) on a risk-contract basis, paying plans based on Average Adjusted Per Capita Costs (AAPCCs). The calculation of the AAPCCs has been criticized on several fronts. A congressional proposal encompassed in the failed 1995 Balanced Budget Act would have altered the formula by which Medicare determines payments to risk- contracting HMOs. Many of its provisions were enacted through the 1997 Balanced Budget Act. This paper models the effect of the earlier proposal on AAPCC rates and discusses the extent to which the proposal and the reforms in the 1995 Balanced Budget Act would address shortcomings identified in the original rate formula. (Inquiry 1998 Spring; 35(1): 62-77).

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

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