Managed Health Care

Journal Article

Mar 6, 2024

Are Disparities in Mental Health Care for Medicaid Beneficiaries Lower in Managed Care?

Medicaid managed care has not improved the inequitable allocation of mental health care across racial and ethnic groups. Attention to monitoring of racial and ethnic differences in use of mental health care in Medicaid managed care is warranted.

Journal Article

Mar 4, 2022

Content and Actionability of Recommendations to Providers After Shadow Coaching

This study aimed to examine the content of the recommendations given to providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.

Report

Dec 2, 2021

Nurse examines an older female patient, photo by SDI Productions/Getty Images

New York State 1115 Demonstration Independent Evaluation: Interim Report

This report examines whether two components of New York State's Medicaid Section 1115 Waiver—the Managed Long-Term Care (MLTC) program and the 12-month continuous eligibility policy—have achieved their goals.

Journal Article

Feb 12, 2021

Care Management Reduced Infant Mortality for Medicaid Managed Care Enrollees in Ohio

The Ohio Department of Medicaid introduced requirements to be delivered by Medicaid managed care organizations (MCOs). This study evaluated the impact of care management on reducing infant mortality in the largest Medicaid MCO in Ohio.

Journal Article

Dec 12, 2019

The Challenge of Determining Appropriate Care in the Era of Patient-Centered Care and Rising Health Care Costs

The goal of health care is to ensure that patients receive the right care for the right patient for the right problem at the right time from the right provider. Inappropriate care is costly. The challenge is to define and increase delivery of appropriate care.

Journal Article

Aug 20, 2019

Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability

Practice consolidation can increase the stability of physician networks, which may have positive implications for organizational effectiveness.

Journal Article

Jul 26, 2017

Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions

Risk-reduction strategies adopted by Medicare Advantage plans to prevent hospital readmissions have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients.

Journal Article

Jan 25, 2017

Does Medicare Advantage Enrollment Affect Home Healthcare Use?

Medicare Advantage beneficiaries use less home health than do their Fee-for-Service counterparts, but there is marked regional variation in use by both groups.

Journal Article

Oct 18, 2016

Differences in Nursing Home Quality Between Medicare Advantage and Traditional Medicare Patients

Researchers found little difference in the quality of nursing home care provided to Medicare enrollees in managed care and those enrolled in traditional fee-for-service nursing homes.

Commentary

Apr 19, 2016

Introducing Value-Based Purchasing into TRICARE Reform

Congress is considering how to update TRICARE, the U.S. Department of Defense health benefits program. In this Perspective, the authors evaluate two existing proposals that incorporate value-based purchasing and describe a hybrid alternative.

Dissertation

Feb 19, 2016

Once A Cure; Second A Waste: Examining Hospital Readmission Rates of the Commercially Insured Under 65 Population

Uses a dataset that covers inpatient hospital admissions of a population of commercially insured patients under age 65 from California during 2003-2012, this dissertation makes contributions to the knowledge gap in the literature.

Journal Article

Jul 7, 2015

Innovative Care Models for High-Cost Medicare Beneficiaries: Delivery System and Payment Reform to Accelerate Adoption

This paper illustrates how Medicare Advantage plans and accountable care organizations could benefit from adopting innovative care delivery models, and suggests policy changes to accelerate spread.

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Managed Health Care

Managed Health Care

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Are Disparities in Mental Health Care for Medicaid Beneficiaries Lower in Managed Care?

Content and Actionability of Recommendations to Providers After Shadow Coaching

New York State 1115 Demonstration Independent Evaluation: Interim Report

Care Management Reduced Infant Mortality for Medicaid Managed Care Enrollees in Ohio

The Challenge of Determining Appropriate Care in the Era of Patient-Centered Care and Rising Health Care Costs

Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability

Medicare Advantage Associated With More Racial Disparity Than Traditional Medicare For Hospital Readmissions

Does Medicare Advantage Enrollment Affect Home Healthcare Use?

Differences in Nursing Home Quality Between Medicare Advantage and Traditional Medicare Patients

Introducing Value-Based Purchasing into TRICARE Reform

Once A Cure; Second A Waste: Examining Hospital Readmission Rates of the Commercially Insured Under 65 Population

Innovative Care Models for High-Cost Medicare Beneficiaries: Delivery System and Payment Reform to Accelerate Adoption

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