Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI.
Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI.
Health Serv Res. 2018 Oct;53(5):3770-3789. doi: 10.1111/1475-6773.13000. Epub 2018 Jun 27.
To assess the impact of assignment to a Medicaid-focused versus mixed managed care plan on continuity of Medicaid coverage.
2011-2016 Medicaid claims from a Northeastern state.
Following the exit of a Medicaid managed care insurer, Medicaid administrators prioritized provider networks in reassigning enrollees, but randomly assigned beneficiaries whose providers were equally represented in the two plans. We leveraged the natural experiment created by random plan assignment and conducted an instrumental variable analysis.
We analyzed Medicaid claims for 12,083 beneficiaries who were members of the exiting Blue Cross Blue Shield plan prior to January 1, 2011.
Managed care plan type did not significantly impact continuous enrollment in the Medicaid program. Greater outpatient utilization and the presence of a special need among children were associated with longer enrollment in Medicaid.
Managed care plans did not differ in their capacity to keep Medicaid beneficiaries continuously enrolled in coverage, despite differences in plan features.
评估分配给以医疗补助为重点的管理式医疗计划与混合管理式医疗计划对医疗补助覆盖连续性的影响。
来自美国东北部一个州的 2011-2016 年医疗补助数据。
在医疗补助管理式医疗保险公司退出后，医疗补助管理人员在重新分配参保人的医疗补助提供商网络时优先考虑，但随机分配了那些在两个计划中提供商数量相等的受益人的保险计划。我们利用随机计划分配所产生的自然实验，进行了工具变量分析。
我们分析了 12083 名在 2011 年 1 月 1 日前是蓝十字蓝盾计划成员的受益人的医疗补助数据。
管理式医疗计划类型对医疗补助计划的连续参保没有显著影响。儿童的门诊利用率较高和存在特殊需求与医疗补助的参保时间延长有关。
尽管计划特征存在差异，但管理式医疗计划在保持医疗补助受益人的参保连续性方面没有差异。
