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Multi-Site Implementation: Medicaid Section 1931(b) in California

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Author Info
Jacob Alex Klerman
Amy G. Cox
Abstract

This paper uses the implementation of the new Medicaid 1931(b) program in California and its 58 counties to consider multi-site implementation. Given California's county-operated welfare system, the California Department of Health Services (CDHS) made policy that each of the state's 58 counties was to implement. Combining unusually rich administrative data, official documents, and qualitative field work, the authors find that actual implementation occurred as much as several years later than was required by state-level policy, with considerable heterogeneity across the counties, and that the heterogeneity was to a great extent due to the details of computer systems. The paper concludes with a discussion of the implications of these results for implementation and the study of implementation.

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File URL: http://www.rand.org/pubs/working_papers/2005/RAND_WR249.pdf
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Paper provided by RAND Corporation Publications Department in its series Working Papers with number 249.

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Length: 33 pages
Date of creation: Mar 2005
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Handle: RePEc:ran:wpaper:249

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Related research
Keywords: implementation; field-work; Medicaid;

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June. [Downloadable!] (restricted)
  2. Moffitt, Robert & Wolfe, Barbara L, 1992. "The Effect of the Medicaid Program on Welfare Participation and Labor Supply," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 615-26, November. [Downloadable!] (restricted)
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