By Christopher Flavelle
Medicaid managed-care plans that provide low access to health services may increase long-term medical costs, according to a Bloomberg Government Study, “Evidence is Limited that Medicaid Managed Care Reduces ER Visits.” Health-care policy analyst Christopher Flavelle looks at the performance of managed care in the biggest states.
State policymakers, caught between stagnant tax revenue and increasing spending demands, are moving more of their Medicaid beneficiaries into managed-care plans run by private insurers. Those plans seek to reduce costs by focusing attention on those who need it most, while reducing the use of unnecessary services.
This Bloomberg Government Study, the second of three parts, examines the impact of managed care on access to care and on health outcomes in the five most populous states. It also looks at the frequency of emergency-room visits compared with beneficiaries in traditional, fee-for-service Medicaid. (The first installment of this series examined the causes of the shift to managed care.)
Access to care, health outcomes and ER visits can be indicators of future medical costs. This study analyzes these measures to gauge the ability of Medicaid managed care to produce sustainable savings for state governments, and shows reasons for concern over the long term. Failure to meet that goal may damp or reverse the shift toward managed care, or it may lead the worst-performing plans to be excluded from some states’ markets, especially if the new health-care law increases scrutiny of the Medicaid program.
Read the complete study here.
Read the part one of the series, “Managed-Care Push Not Explained By Medicaid Cost Growth Alone.”
Christopher Flavelle is a health-care policy analyst for Bloomberg Government. He holds a master’s degree from Columbia University’s School of International and Public Affairs and a bachelor’s degree from McGill University. Before Bloomberg, he examined the 2009 U.S. stimulus package for ProPublica, the investigative news group in New York.