Medicaid Managed Care and Infant Health: A National Evaluation
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.
|Date of creation:||May 2002|
|Date of revision:|
|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.|
|Contact details of provider:|| Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.|
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- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
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