Review
Perils of pioneering: monitoring Medicaid managed care
Affiliations
- PMID: 12500321
- PMCID: PMC4194661
Item in Clipboard
Review
Perils of pioneering: monitoring Medicaid managed care
Health Care Financ Rev.
2000 Winter.
Abstract
This article reviews Federal and State oversight of section 1115 Medicaid managed care demonstrations in Hawaii, Oklahoma, Rhode Island, and Tennessee from 1994 to 1998. Under Medicaid managed care, the Federal Government and States have had to shift their focus and resources into oversight functions that barely existed in fee-for-service (FFS) Medicaid. We find that managed care monitoring was slow to begin and not always adequate in these demonstrations. While State and Federal monitoring have improved over time, monitoring is not yet at the point of ensuring access and quality.
Similar articles
-
Federally qualified health centers: surviving Medicaid managed care, but not thriving.Health Care Financ Rev. 2000 Winter;22(2):103-17. Health Care Financ Rev. 2000. PMID: 12500323 Free PMC article. Review.
-
Medicaid managed care and high quality. Can we have both?JAMA. 1997 Nov 19;278(19):1617-21. JAMA. 1997. PMID: 9370510 No abstract available.
-
Innovations in section 1115 demonstrations.Health Care Financ Rev. 2000 Winter;22(2):49-59. Health Care Financ Rev. 2000. PMID: 12500320 Free PMC article.
-
TennCare: Tennessee's answer to runaway Medicaid costs.Manag Care Q. 1999 Spring;7(2):6-14. Manag Care Q. 1999. PMID: 10537643
-
Reconciling practice and theory: challenges in monitoring Medicaid managed-care quality.Health Care Financ Rev. 1995 Summer;16(4):85-105. Health Care Financ Rev. 1995. PMID: 10151896 Free PMC article. Review.
Cited by
-
Evolution of Medicaid managed care systems and eligibility expansions.Health Care Financ Rev. 2000 Winter;22(2):7-27. Health Care Financ Rev. 2000. PMID: 12500318 Free PMC article.
-
Medicaid reform in the 1990s.Health Care Financ Rev. 2000 Winter;22(2):1-5. Health Care Financ Rev. 2000. PMID: 12500317 Free PMC article. No abstract available.
References
-
- Birch and Davis Health Management Corporation. Plan for Monitoring RIte Care Health Plans. Birch and Davis; Cranston, RI.: May, 1996a. Prepared for the Rhode Island Office of Managed Care, Department of Human Services.
-
- Birch and Davis Health Management Corporation. RIte Care 1996 Access Study Final Report. Birch and Davis; Cranston, RI.: Mar, 1996b. Prepared for the Rhode Island Office of Managed Care, Department of Human Services.
-
- Federal Register. Medicaid Program; Medicaid Managed Care; Proposed Rule. Federal Register. 1998 Sep 29;63(188):52022. - PubMed
-
- FMH, Inc. Hawaii Health QUEST Medical Early Periodic Screening, Diagnosis, and Treatment Program Study Report. Oct, 1997. Prepared for Med-QUEST Division, Hawaii Department of Human Services.
-
- Health Care Financing Administration. Draft Monitoring Response to Hawaii. Baltimore, MD.: Aug, 1997.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical