Incentivizing Care Coordination in Managed Care

Care coordination for children remains one of the least-understood, widespread practice and policy interventions in pediatrics. In "Medicaid Managed Care Structures and Care Coordination: A National Cross-Sectional Analysis," Gilchrist-Scott and colleagues examine the degree to which state penetrance of Medicaid managed care structures (specifically, health maintenance organizations [HMOs] versus primary care case management [PCCM]) may incentivize care coordination. They find that states with lower HMO and higher PCCM penetrance exhibited greater care coordination on 2 parent-reported National Survey of Children's Health (NSCH) metrics: access to care coordination and receipt of care coordination when needed. Given that NSCH data were cross-sectional and penetrance data were aggregated by state, no causal inferences can be made, but the findings are intriguing nonetheless.