Title

Explaining Variations in Medicaid Managed Care Program Coverage

Document Type

Article

Publication Date

8-11-2011

Publication Source

International Journal of Policy Studies

Volume

2

Issue

1

Inclusive pages

57-72

Publisher

Korean Association for Policy Studies

Place of Publication

Seoul, Republic of Korea

Peer Reviewed

yes

Abstract

This paper explores variations in the coverage of medical services and groups of beneficiaries of the Medicaid managed care programs in the American states. Program variations – the comprehensiveness of coverage – are investigated in relation to states’ internal and external characteristics utilizing Zero Inflated Negative Binomial Regression Model (ZINBRM). To measure the comprehensiveness, we construct a composite score of program coverage for 70 first adopted managed care programs separately for the Primary Care Case Management (PCCM) and risk-based programs. The results of the analyses demonstrate that the political dynamics behind the two programs differ. Both approaches are affected in a similar manner by unified Democratic Party control, physicians per population, and generosity. Years since program adoption, the comprehensiveness of neighboring state programs, urban population, and the federal matching rate affect PCCM programs while having no effect on risk-based programs. On the other hand, management capacity affects the comprehensiveness of risk-based programs negatively while having no effect on PCCM programs.

Keywords

Medicaid managed care, Program Coverage, Policy Reinvention and Diffusion, State Politics

Disciplines

Health Policy | Other Political Science | Public Affairs, Public Policy and Public Administration | Public Policy

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