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. 1986;1986(Spec No):21-30.

Overview of Medicaid capitation and case-management initiatives

D A Freund, E Neuschler

Overview of Medicaid capitation and case-management initiatives

D A Freund et al. Health Care Financ Rev. 1986.

Abstract

Case-management programs have grown in number and in acceptance in the Medicaid program since 1981. In this article, we review their structure and incentives as well as what is known about their impact on cost and use. These programs also have been difficult to implement, posing myriad management challenges for prepaid program managers and State administrators. We highlight the problems in the following areas: eligibility, enrollment, rate setting, and management information systems.

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References

    1. Bell James, Associates . Medicaid Program Evaluation. Arlington, Va.: 1983. Contract No. HCFA 500-83-0058. Prepared for the Department of Health and Human Services.
    1. Code of Federal Regulations: Title 42, Part 434, Subpart A, Section 434.2. Nov. 1983.
    1. Freeman H, Kirkman-Liff B. Health care under AHCCCS: An examination of Arizona's alternative to Medicaid. Health Services Research. 1985;20(3):245–66. - PMC - PubMed
    1. Freund D. Medicaid Reform: Four Studies of Case Management. Washington, D.C.: American Enterprise Institute; 1984.
    1. Freund D. The private delivery of Medicaid services: Lessons for administrators, providers, and policymakers. Journal of Ambulatory Care Management. 1986;9(2):54–65. - PubMed

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