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Managed care. Dealing with the dual eligible population.

J Gong1

  • 1Health Dimensions, Minneapolis, MN, USA.

Contemporary Longterm Care
|October 4, 1997
PubMed
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This review examines the origins of managed care programs for individuals eligible for both Medicare and Medicaid. Future installments will explore state-specific programs and their effects on long-term care services.

Area of Science:

  • Health Services Research
  • Public Health Policy

Background:

  • Dual eligibility for Medicare and Medicaid presents complex healthcare needs.
  • Understanding the historical development of managed care is crucial for optimizing care delivery.

Purpose of the Study:

  • To review the genesis of managed care programs for dually eligible individuals.
  • To lay the groundwork for analyzing the impact of state-specific programs in subsequent research.

Main Methods:

  • Literature review of historical documents and policy analyses.
  • Synthesis of information on the evolution of managed care for this population.

Main Results:

  • The development of managed care for dually eligible persons is a complex historical process.

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  • Early initiatives aimed to integrate services and control costs.

    • Conclusions:

    • The historical context of managed care for Medicare and Medicaid enrollees is essential for understanding current challenges.
    • Further research is needed to evaluate the effectiveness of various state-level managed care models.