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Erschienen in: International Journal of Health Economics and Management 2/2018

14.10.2017 | Research Article

Does capitated managed care affect budget predictability? Evidence from Medicaid programs

verfasst von: Victoria Perez

Erschienen in: International Journal of Health Economics and Management | Ausgabe 2/2018

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Abstract

As the second largest item in the budget of every US state, Medicaid budget stability and financial transparency have significance for every state. This study is the first to test whether managed care enrollment reduces the variance of Medicaid spending, in contrast to the focus of the existing literature on spending levels. This variance bears directly on whether budget constrained states whether budget constrained states benefit from managed care in the form of stabilized spending, leading to improved budget predictability. Capitated payments stabilize spending at the margin, but the effects may be unobservable in aggregate due to variation in enrollment, which is directly measured in the analysis, or selection bias, which is unobserved. Although the majority of Medicaid enrollees are in managed care, the study shows that managed care use has been concentrated among the enrollees with the most stable spending, resulting in only small gains to budget predictability. This finding is robust to the exclusion of the claims expenditures that exhibit the most variance.
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Fußnoten
1
Medicaid managed care is implemented at the request of state governors and/or the Medicaid directors they appoint. While Medicaid directors are not publicly elected, they are hired by the governor’s office.
 
2
For example, see Feigenbaum (2009) and Buchanan (2012).
 
3
This study focuses on differences between estimated and actual spending, rather than differences between state revenue and outlays. This distinction excludes long-term investments in economic growth, which may require short-term spending that exceeds revenue, from the analysis.
 
4
The Balanced Budget Act of 1997 capped the relative contribution of other state funding at 25 percent of Medicaid spending. Few states reach this cap during the study period.
 
5
 
6
Cliff Rosenberger: News, Ohio House Sends Budget Bill To Governor Kasich. Accessed 26 September 2017. http://​cliffrosenberger​.​com/​ohio-house-sends-budget-bill-to-governor-kasich/​.
 
7
Pear, R. “As Number of Medicaid Patients Goes Up, Their Benefits Are About to Drop.” New York Times, 6/15/2011. Accessed 9/26/2014.
 
8
Direct analysis of Medicaid enrollment levels and composition, as well as state population estimates from the Kaiser Family Foundation (2015).
 
9
Projections of Medicaid expenditures are generated by a uniform process across states and there is little documentation about how these projections are estimated. To inform federal policy, CMS uses expenditure reports and claims data to generate predictions in enrollment, utilization, and price by service line and enrollee type (Matthews Burwell 2015). However, state Medicaid offices factor other elements of the state economy into their projections, which would be excluded in the CMS method.
 
10
Recently, for example, Alabama State Sen. Paul Sanford set up a GoFundMe campaign with the stated motive of offsetting the state’s deficits, which he later acknowledged as a tactic to raise awareness of the deficit itself and impending tax increases (Watkins 2015).
 
11
“Beshear outlines efforts to privatize some Medicaid services” WDRB 41 Louisville News, 7/7/2011. Accessed 9/26/2014.
 
12
In the data, the correlation coefficient is \(-0.04\) and not statistically significant.
 
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Metadaten
Titel
Does capitated managed care affect budget predictability? Evidence from Medicaid programs
verfasst von
Victoria Perez
Publikationsdatum
14.10.2017
Verlag
Springer US
Erschienen in
International Journal of Health Economics and Management / Ausgabe 2/2018
Print ISSN: 2199-9023
Elektronische ISSN: 2199-9031
DOI
https://doi.org/10.1007/s10754-017-9227-7

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