Medicaid Managed Care Reform: Making It Work for Children

Medicaid managed care and children: an overview.

In recent years, states have increasingly turned to managed care arrangements for financing and delivering health services to Medicaid beneficiaries. In 1996, approximately 40% of all Medicaid recipients were enrolled in some form of managed care. The rapid escalation of managed care in this population has been fueled by states' desire to slow the growth of Medicaid expenditures and by the tren...

Health Reform, Year Seven: Observations About Medicaid Managed Care

Over the last 7 years, State and Federal policymakers have reformed State medical assistance programs and, in the process, have grappled with goals of both containing program costs and expanding health insurance coverage to the uninsured. Currently, nearly one-quarter of all States have implemented health care reform demonstrations, and this article summarizes trends seen since health care refo...

Making sense of Medicaid reform.

“Second-Generation” Medicaid Managed Care: Can It Deliver?

This article offers insight into what we term "second-generation" Medicaid managed care. In case studies of seven States, we examined three critical questions: (1) Does managed care experience facilitate program operations? (2) Can Medicaid managed care deliver on important goals? and (3) Can States extend the program beyond low-income families and children to others? The answers are encouragin...

Coverage decision-making in Medicaid managed care: key issues in developing managed care contracts.

Coverage provisions are the most complex part of any managed care contract. This is particularly true for Medicaid agencies, because of important differences between Medicaid and insurance. This Issue Brief identifies general issues that should be addressed by States as managed care contracts are developed and drafted, and it specifically explores the challenges faced by public purchasers when ...