Review includes a collection of articles on managed care topics in the public programs of Medicaid and Medicare. The first article looks at developments in Medicaid in the broader context of overall changes in the managed care marketplace, while the remaining articles examine specific topics that have significant policy implications for the public sector programs. Leading off this issue, Hurley...

BACKGROUND The Affordable Care Act (ACA) expands Medicaid's tobacco dependence treatment (TDT) coverage; however, these expansions differ in comprehensiveness based on Medicaid eligibility category. PURPOSE To examine whether more generous Medicaid TDT coverage (in terms of cost-sharing requirements and treatments covered) is associated with greater likelihood of quit attempts and successful ...

From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from fee-for-service into managed care would lead to an increa...

Policymakers have focused primarily on increasing Medicaid reimbursement rates to increase physicians' participation in Medicaid, although physicians often complain of payment delays and other administrative burdens associated with Medicaid. Linking state-level data on average reimbursement times to the 2004-05 Community Tracking Study Physician Survey, this study examines how Medicaid reimburs...

Individuals eligible in both Medicaid and Medicare, the dually eligible enrollees, account for a disproportionate share of Medicaid utilization and payments. While comprising 14.7 percent of the Medicaid population, they accounted for 40.5 percent of Medicaid payments in 2002. Mean reimbursement for the dually eligible enrollees was nearly four times that of non-dually eligible Medicaid enrolle...

OBJECTIVE To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children. DATA 2007 and 2011-2012 National Survey of Children's Health. STUDY DESIGN Difference-in-differences and triple differences models were used to measure the impact of reforms. PRINCIPAL FINDINGS ...

Medicaid reimburses physicians at a lower rate and fewer physicians participate in Medicaid when compared to other insurance types. To encourage provider participation in Medicaid, the Affordable Care Act (ACA) increased Medicaid fees to Medicare levels for primary care providers in 2013 and 2014. As expected, the bump in fees resulted in an increase in primary care appointment availability for...

The old age provisions of the Medicaid program were designed to insure retirees against medical expenses. We estimate a structural model of savings and medical spending and use it to compute the distribution of lifetime Medicaid transfers and Medicaid valuations across currently single retirees. Compensating variation calculations indicate that current retirees value Medicaid insurance at more ...

The study compares racial differences in access to highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) patients under Medicaid managed care and Medicaid fee-for-service (FFS). This study uses the HIV Cost and Services Utilization Study (HCSUS) data set. The analysis includes Black and White Medicaid enrollees with HIV/AIDS in 1996. Logistic regression is used to ...

Expenditures for the Medicaid program grew at the alarming and unexpected average annual rate of nearly 20 percent from 1989 ($58 billion) to 1992 ($113 billion). These statistics raise a critical question: What caused spending to grow so dramatically? Using State-level data from 1984-92, this analysis examines the determinants of Medicaid expenditure growth. The results indicate that Medicaid ...