Medicaid Managed Care and Community Providers: New Partnerships, Debra J. Lipson, July/August 1997, 29 pp. Published in Health Affairs 1997; 16(4): 91-119.
Assuring Quality of Care for Children in Medicaid: EPSDT in a Time of Changing Policy, National Institute for Health Care Management, April 1996, 37 pp. This paper is the product of an October 1995 meeting in which representatives from the U.S. Health Care Financing Administration (HCFA), state Medicaid agencies and health plans discussed some of the problems experienced in implementing managed care programs as well as effective managed care strategies that provide high-quality EPSDT services to children. Among the concerns voiced were the difficulties involved with balancing tight budgets, vague requirements, lack of specific data on EPSDT and states' desire for greater flexibility in program design.
State Health Care Reform: Recent Activity, The States and Private Sector: Leading Health Care Reform, Lewin-VHI/Alpha Center, May 1995, 57 pp., fourth in a series. States vary in their efforts at health care reform, and this report attempts to clarify whether there is a correlation between the number of initiatives and actual achievements in health care reform goals. The report categorizes state health care reform strategies and systematically compares these reforms in two indices: an access reform index and an overall reform index.
Fact Sheet: Medicaid Managed Care, National Institute for Health Care Management, February 1995, 2 pp. This fact sheet provides information on Medicaid coverage, expenditures, and services. It also summarizes Medicaid managed care coverage and waivers to implement strategies to move the Medicaid population into a managed care plan.
Medicaid: The Move to Managed Care, National Institute for Health Care Management, National Governors' Association and the Federation of American Health Systems, February 1995, 12 pp. This issue brief reviews the development and growth of Medicaid managed care and identifies policy and implementation issues to consider as state Medicaid programs increase their use of managed care arrangements. Key areas of debate include: appropriate types of federal vs. state policy decisions, infrastructure/capacity development, and monitoring quality and service.
States As Payers: Managed Care for Medicaid Populations, The States and Private Sector: Leading Health Care Reform, Lewin-VHI, February 1995, second in a series. This report provides an overview of Medicaid managed care. It includes a description of the three major models of managed care implemented by states, an examination of variation in recipients and areas covered, an analysis of the effect of mandatory versus voluntary enrollment, and a comparison to private sector managed care. The paper presents an analysis of the type and extent to which Medicaid managed care has been implemented in each of the 50 states as of June 1994.