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Medicaid Managed Care and Infant Health: A National Evaluation

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  • Robert Kaestner
  • Lisa Dubay
  • Genevieve Kenney

Abstract

In this study, we examine the effects of Medicaid managed care (MMC) on prenatal care utilization and infant health. We obtain separate estimates of the effect of primary care case management (PCCM) managed care programs and HMO managed care plans on prenatal care utilization, birth weight, and cesarean section. The results suggest the following: MMC was associated with a small, clinically unimportant decrease in the number of prenatal care visits; MMC had no statistically significant relationship to the APNCU index of the adequacy of prenatal care; MMC was associated with a significant increase in the incidence of low-birth weight and pre-term birth; and MMC had no association with the incidence of cesarean section. We argue that a causal interpretation of the first and third findings is unsupported by a careful reading of the evidence, and we conclude that Medicaid managed care had virtually no causal effect on, prenatal care use, birth outcomes, and cesarean section.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8936.

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Date of creation: May 2002
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Publication status: published as Kaestner, Robert, Lisa Dubay and Jenny Kenney. “Managed Care and Infant Health: An Evaluation of Medicaid in the US.” Social Science and Medicine 60 (2005): 1815-1833.
Handle: RePEc:nbr:nberwo:8936

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  1. Sherry Glied & Jane Sisk & Sheila Gorman & Michael Ganz, 1997. "Selection, Marketing, and Medicaid Managed Care," NBER Working Papers 6164, National Bureau of Economic Research, Inc.
  2. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
  3. Freund, D.A. & Kniesner, T.J. & LoSasso, A.T., 1996. "How Managed Care Affects Medicaid Utilization: A Synthetic Difference-in-Difference Zero-Inflated Count Model," Discussion Paper 1996-40, Tilburg University, Center for Economic Research.
  4. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
  5. Glied, Sherry, 2000. "Managed care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 13, pages 707-753 Elsevier.
  6. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 2001. "Medical malpractice liability and its effect on prenatal care utilization and infant health," Journal of Health Economics, Elsevier, vol. 20(4), pages 591-611, July.
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Cited by:
  1. Mark J. Holmes, 2005. "Is Long-Run Output Convergence Associated With International Cooperation? Some New Evidence For Selected African Countries," Journal of Economic Development, Chung-Ang Unviersity, Department of Economics, vol. 30(2), pages 67-85, December.
  2. Mark Duggan, 2002. "Does Contracting Out Increase the Efficiency of Government Programs? Evidence from Medicaid HMOs," NBER Working Papers 9091, National Bureau of Economic Research, Inc.
  3. Anna Aizer & Janet Currie & Enrico Moretti, 2004. "Competition in Imperfect Markets: Does it Help California's Medicaid Mothers?," NBER Working Papers 10429, National Bureau of Economic Research, Inc.

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