2012
DOI: 10.1215/03616878-1672727
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The Evolution of an Innovation: Variations in Medicaid Managed Care Program Extensiveness

Abstract: This article utilizes a theoretical framework of policy innovation, diffusion, and reinvention to investigate the evolving nature of Medicaid managed care programs over time. By estimating two separate models, one for primary care case management (PCCM) and a second for risk-based program enrollment, this study seeks to disentangle two different paths of learning (internal and external), investigate the potential effects of vertical diffusion of policy, and examine the impact of internal state characteristics … Show more

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Cited by 11 publications
(11 citation statements)
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“…Previous research finds that less-affluent states are sensitive to fiscal incentives. For example, fiscal incentives tend to prod less-afñuent states more than their wealthier counterparts to increase Medicaid enrollment in managed care (Kim and Jennings 2012). The decisions of some states seem to confirm the impact of fiscal enticements.…”
Section: Economic Circumstancesmentioning
confidence: 99%
See 1 more Smart Citation
“…Previous research finds that less-affluent states are sensitive to fiscal incentives. For example, fiscal incentives tend to prod less-afñuent states more than their wealthier counterparts to increase Medicaid enrollment in managed care (Kim and Jennings 2012). The decisions of some states seem to confirm the impact of fiscal enticements.…”
Section: Economic Circumstancesmentioning
confidence: 99%
“…For instance, Ae-sook Kim and Edward Jennings (2012) report that state experiments and policy development generate policy learning about Medicaid managed care, which influences the extensiveness of their programs. Henry Glick and Scott Hays (1991: 847) find that the process of creating and then amending policy aflfects the direction and innovativeness of state decision making.…”
Section: Where You Stand Depends On Where You Sitmentioning
confidence: 99%
“…As Rice and Rogers (1980, 501) put it, "an innovation is often really a bundle of components; it is possible to adopt some components and change or reject others." In many policy reinvention studies, the dependent variable is a characteristic such as the "comprehensiveness" or "intensiveness" of policies being diffused (Clark 1985;Glick and Hays 1991;Hays 1996a;Kim and Jennings 2012). Policy comprehensiveness can also be interpreted as the degree of stringency or generosity of policies.…”
Section: Previous Researchmentioning
confidence: 99%
“…Section 1115 of the SSA amendments furthered state variation by allowing states to apply for waivers to conduct research and demonstration projects that bypassed federal rules and regulations. Still, in the years before the ACA, there was wide variation in state Medicaid programs (Kim and Jennings 2012). States responded rapidly, using waivers to increase Medicaid income eligibility levels, raise asset limits, and incorporate groups not categorically eligible (Schneider 1997).…”
Section: Policy Legaciesmentioning
confidence: 99%