Medicaid case management: Kentucky's Patient Access and Care Program.

Area of Science:

• Health Services Research
• Public Health Policy
• Healthcare Management

Background:

• States have explored Medicaid managed care since 1981.
• Goals include improving care access, continuity, and cost containment.
• Reducing inappropriate utilization is a key objective.

Purpose of the Study:

• To evaluate the impact of Primary Care Case Management (PCCM) on healthcare utilization.
• To assess the effectiveness of the Kentucky Patient Access and Care (KenPAC) program.

Main Methods:

• Utilized monthly utilization data from 1984 to 1989.
• Employed an interrupted time-series research design.
• Examined the KenPAC program in Kentucky.

Main Results:

• PCCM significantly reduced the utilization of independent laboratory services.
• PCCM reduced the utilization of physician services.
• PCCM decreased emergency department and outpatient hospital service use.
• PCCM did not significantly affect inpatient hospital or prescription drug utilization.

Conclusions:

• Primary Care Case Management (PCCM) is effective in reducing certain healthcare services utilization.
• KenPAC program demonstrates success in controlling specific healthcare costs.
• Further research may explore long-term impacts and effects on other service types.