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Medicaid managed care: effects on children's Medicaid coverage and utilization

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  • Currie, Janet
  • Fahr, John

Abstract

We use data from the National Health Interview Surveys to measure the effects of the growth of Medicaid managed care on children. We examine both the probability that individual children were Medicaid-covered and their utilization of care. We find that managed care penetration has significant effects on the composition of the Medicaid caseload. Poor white and Hispanic children are more likely to be enrolled in Medicaid where Medicaid managed care organizations are more prevalent, whereas black children are less likely to be enrolled. Also, toddlers are less likely to be enrolled than school age children. These lower enrollment rates are linked to increases in the numbers of black children and toddlers who go without any doctor visits in a year. Our results are consistent with cream-skimming by Medicaid managed care organizations along the lines of race and age.
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  • Currie, Janet & Fahr, John, 2005. "Medicaid managed care: effects on children's Medicaid coverage and utilization," Journal of Public Economics, Elsevier, vol. 89(1), pages 85-108, January.
  • Handle: RePEc:eee:pubeco:v:89:y:2005:i:1:p:85-108
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    Cited by:

    1. Chorniy, Anna & Currie, Janet & Sonchak, Lyudmyla, 2018. "Exploding asthma and ADHD caseloads: The role of medicaid managed care," Journal of Health Economics, Elsevier, vol. 60(C), pages 1-15.
    2. Jonathan Gruber, 2003. "Medicaid," NBER Chapters, in: Means-Tested Transfer Programs in the United States, pages 15-78, National Bureau of Economic Research, Inc.
    3. Lesley J. Turner, 2015. "The Effect of Medicaid Policies on the Diagnosis and Treatment of Children's Mental Health Problems in Primary Care," Health Economics, John Wiley & Sons, Ltd., vol. 24(2), pages 142-157, February.
    4. Lindsey Woodworth, 2016. "A Leak in the Lifeboat: The effect of Medicaid managed care on the vitality of safety-net hospitals," Journal of Regulatory Economics, Springer, vol. 50(3), pages 251-270, December.
    5. Hahn, Youjin, 2013. "The effect of Medicaid physician fees on take-up of public health insurance among children in poverty," Journal of Health Economics, Elsevier, vol. 32(2), pages 452-462.
    6. Marianne P. Bitler & Madeline Zavodny, 2014. "Medicaid: A Review of the Literature," NBER Working Papers 20169, National Bureau of Economic Research, Inc.
    7. Katherine Meckel, 2020. "Is the Cure Worse Than the Disease? Unintended Effects of Payment Reform in a Quantity-Based Transfer Program," American Economic Review, American Economic Association, vol. 110(6), pages 1821-1865, June.
    8. Doiron, Denise & Fiebig, Denzil G. & Suziedelyte, Agne, 2014. "Hips and hearts: The variation in incentive effects of insurance across hospital procedures," Journal of Health Economics, Elsevier, vol. 37(C), pages 81-97.
    9. Duggan, Mark, 2004. "Does contracting out increase the efficiency of government programs? Evidence from Medicaid HMOs," Journal of Public Economics, Elsevier, vol. 88(12), pages 2549-2572, December.
    10. Lee, Ajin, 2020. "How do hospitals respond to managed care? Evidence from at-risk newborns," Journal of Public Economics, Elsevier, vol. 184(C).
    11. Elizabeth L. Munnich & Michael R. Richards, 2020. "Treatment flows after outsourcing public insurance provision: Evidence from Florida Medicaid," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1343-1363, November.
    12. Marc T. Law & Zeynep K. Hansen, 2009. "Medical Licensing Board Characteristics and Physician Discipline: An Empirical Analysis," NBER Working Papers 15140, National Bureau of Economic Research, Inc.
    13. Kaestner, Robert & Dubay, Lisa & Kenney, Genevieve, 2005. "Managed care and infant health: an evaluation of Medicaid in the US," Social Science & Medicine, Elsevier, vol. 60(8), pages 1815-1833, April.
    14. James Marton & Aaron Yelowitz, 2015. "Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky," Southern Economic Journal, John Wiley & Sons, vol. 82(2), pages 535-555, October.
    15. Balsa, Ana I. & Cao, Zhun & McGuire, Thomas G., 2007. "Does managed health care reduce health care disparities between minorities and Whites?," Journal of Health Economics, Elsevier, vol. 26(1), pages 101-121, January.
    16. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    17. Timothy J. Layton & Nicole Maestas & Daniel Prinz & Boris Vabson, 2019. "Private vs. Public Provision of Social Insurance: Evidence from Medicaid," NBER Working Papers 26042, National Bureau of Economic Research, Inc.
    18. Timothy Layton & Alice K. Ndikumana & Mark Shepard, 2017. "Health Plan Payment in Medicaid Managed Care: A Hybrid Model of Regulated Competition," NBER Working Papers 23518, National Bureau of Economic Research, Inc.
    19. John D. Singleton, 2019. "Incentives and the Supply of Effective Charter Schools," American Economic Review, American Economic Association, vol. 109(7), pages 2568-2612, July.
    20. 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.
    21. Cheolmin Kang & Akira Kawamura & Haruko Noguchi, 2019. "Does Free Healthcare Affect Children's Healthcare Use and Outcomes?," Working Papers 1914, Waseda University, Faculty of Political Science and Economics.
    22. Victoria Perez, 2018. "Does capitated managed care affect budget predictability? Evidence from Medicaid programs," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 123-152, June.
    23. Bradley Herring & E. Kathleen Adams, 2011. "Using HMOs to serve the Medicaid population: what are the effects on utilization and does the type of HMO matter?," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 446-460, April.
    24. Marton, James & Yelowitz, Aaron & Talbert, Jeffery C., 2014. "A tale of two cities? The heterogeneous impact of medicaid managed care," Journal of Health Economics, Elsevier, vol. 36(C), pages 47-68.
    25. David Zimmer, 2010. "The effect of double coverage on health care utilization of children," Applied Economics, Taylor & Francis Journals, vol. 42(24), pages 3105-3117.

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    More about this item

    JEL classification:

    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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