Medicaid Managed Care Programs In Rural Areas: A Fifty-State Overview

Slifkin, Rebecca T.; Hoag, Sheila; Silberman, Pam; Felt-Lisk, Suzanne; Popkin, B.M.

doi:10.1377/hlthaff.17.6.217

Cited by 27 publications

(22 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 By 1997 (the year covered by the data in this study), 48% of Medicaid beneficiaries were enrolled in managed care (CMS 2000). 2 Research shows that states often have avoided trying to move beyond PCCM in rural areas because of inadequate provider supply, limited willingness of capitated plans to operate in rural areas, and a general lack of understanding of managed care concepts (Slifkin et al 1998). 3 Many Medicaid programs do not require HMOs to contract to provide certain specialized services and, instead, carve these services out of the capitated rates and the HMOs' contractual obligations.…”

Section: Discussionmentioning

confidence: 99%

Has Medicaid Managed Care Affected Beneficiary Access and Use?

Zuckerman

Brennan²,

Yemane³

2002

INQUIRY

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Has Medicaid Managed Care Affected Beneficiary Access and Use?

Zuckerman

Brennan²,

Yemane³

2002

INQUIRY

View full text Add to dashboard Cite

“…Some but not all states included rural areas in MMC (Slifkin et al 1998). In rural areas, the theoretical advantages of market competition did not necessarily apply (Kronick et al 1993).…”

Section: Background On MMCmentioning

confidence: 99%

Multimethod Evaluation of Health Policy Change: An Application to Medicaid Managed Care in a Rural State

Waitzkin

Schillaci

Willging

2008

Health Services Research

View full text Add to dashboard Cite

Objective. To answer questions about the impacts of Medicaid managed care (MMC) at the individual, organizational/community, and population levels of analysis. Data Sources/Study Setting. Multimethod approach to study MMC in New Mexico, a rural state with challenging access barriers. Study Design. Individual level: surveys to assess barriers to care, access, utilization, and satisfaction. Organizational/community level: ethnography to determine changes experienced by safety net institutions and local communities. Population level: analysis of secondary databases to examine trends in preventable adverse sentinel events. Data Collection/Extraction Methods. Survey: multivariate statistical methods, including factor analysis and logistic regression. Ethnography: iterative coding and triangulation to assess documents, field observations, and in-depth interviews. Secondary databases: plots of sentinel events over time. Principal Findings. The survey component revealed no consistent changes after MMC, relatively favorable experiences for Medicaid patients, and persisting access barriers for the uninsured. In the ethnographic component, safety net institutions experienced increased workload and financial stress; mental health services declined sharply. Immunization rate, as an important sentinel event, deteriorated. Conclusions. MMC exerted greater effects on safety net providers than on individuals and did not address problems of the uninsured. A multimethod approach can facilitate evaluation of change in health policy.Key Words. Medicaid managed care, safety net, multimethod research, access, ethnographyIn health services research, the problem of how to evaluate the results of policy change has remained challenging (Evaluation Gap Working Group 2006

show abstract

“…Public health departments in cities have been affected by the expansion of managed care as health plans have taken on the treatment of populations once considered solely the responsibility of health departments (29,51). There are limited examples of managed-care effects on rural public health departments, although health departments in general are scaling back direct patient services (94). There is evidence that, in states with Medicaid managed-care programs, public health departments more often have dropped well-child services.…”

Section: Rural Public Healthmentioning

confidence: 99%

The Changing Nature of Rural Health Care

Ricketts

2000

Annu. Rev. Public Health

198

154

View full text Add to dashboard Cite

Key Words policy, distribution of health professionalss Abstract The rural health care system has changed dramatically over the past decade because of a general transformation of health care financing, the introduction of new technologies, and the clustering of health services into systems and networks. Despite these changes, resources for rural health systems remain relatively insufficient. Many rural communities continue to experience shortages of physicians, and the proportion of rural hospitals under financial stress is much greater than that of urban hospitals. The health care conditions of selected rural areas compare unfavorably with the rest of the nation. The market and governmental policies have attempted to address some of these disparities by encouraging network development and telemedicine and by changing the rules for Medicare payments to providers. The public health infrastructure in rural America is not well understood but is potentially the most fragile aspect of the rural health care continuum.

show abstract

Medicaid Managed Care Programs In Rural Areas: A Fifty-State Overview

Cited by 27 publications

References 2 publications

Has Medicaid Managed Care Affected Beneficiary Access and Use?

Has Medicaid Managed Care Affected Beneficiary Access and Use?

Multimethod Evaluation of Health Policy Change: An Application to Medicaid Managed Care in a Rural State

The Changing Nature of Rural Health Care

Contact Info

Product

Resources

About