Explaining States’ Variations in Medicaid Managed Care Program Coverage

Document Type


Presentation Date


Conference Name

KAPS (Korean Association for Public Policy) International Conference

Conference Location

Seoul, Republic of Korea


The U.S. states have transformed their health care delivery and financing systems into managed care since 1990s. By 2005, over 60% Medicaid populations are covered under managed care health plans. This substantial change targets at containing costs, improving quality, and enhancing access to care. Since state governments have substantial discretion to design their programs given the Federal government’s guideline, program characteristics vary substantially across states. This paper will investigate states’ variations in terms of program coverage – medical services and Medicaid population served. We ask two main questions. First, how much does the program vary across states over time? Second, what factors contribute to explaining the variations? We will test the impacts of states’ internal characteristics, such as socio-demographic, political, economic conditions, and external factors. At the same time, time effects on the extensiveness of Medicaid managed care programs will also be tested. Finally, the potential impacts of this transition under the objectives of changing the systems more cost-effective and fairer will be discussed.


Medicaid Managed Care, Program Coverage, State Health Politics


Public Affairs, Public Policy and Public Administration

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