Periods of Unmanaged Care in Medicaid Managed Care

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Posted to Web: August 01, 2005
Permanent Link: http://www.urban.org/url.cfm?ID=1000847
Managing children's care in Medicaid is difficult if they experience inadequate tenures in health plans. Case studies of five states found that children's tenures in health plans was two to four months shorter than their (often short) tenures in Medicaid itself. Major reasons for the discrepancy were retroactive enrollment practices in Medicaid and delays in enrollees' selection of a health plan. Frequent and burdensome Medicaid recertification processes exacerbate the problem, frequently resulting in breaks in enrollment in Medicaid and the need to reenroll in health plans. The value of managed care for children in Medicaid is undermined as a consequence. (Journal of Health Care for the Poor and Underserved. 2005; 16:444-452)

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