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Women's health services: restructuring for Medicaid managed care
J Loughlin1, E F Bronner, J S Mascari
1Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
The Journal of Ambulatory Care Management
|March 8, 1997
Summary
New Jersey
Area of Science:
- Healthcare Management
- Public Health Policy
Background:
- New Jersey healthcare providers are undergoing significant transformation due to the shift towards managed care.
- Managed care enrollment is substantial, with over 24% of the state's population in commercial plans.
- Medicaid is transitioning to a managed care model to enhance service delivery for recipients.
Purpose of the Study:
- To analyze the impact of managed care adoption on New Jersey's healthcare system.
- To highlight the challenges and acceleration required for managed care evolution in communities with high Medicaid populations.
Main Methods:
- Analysis of managed care enrollment data for commercial and Medicaid populations in New Jersey.
- Review of state initiatives for transitioning Medicaid to a managed care model.
Main Results:
- Over 24% of New Jersey's population is enrolled in commercial managed care plans.
- 82% of New Jersey's Aid to Families with Dependent Children (AFDC) population is enrolled in managed care.
- The state plans to enroll an additional 400,000 Medicaid beneficiaries into managed care.
Conclusions:
- New Jersey is rapidly adopting managed care across both commercial and public health sectors.
- Communities with high Medicaid populations face accelerated pressure to adapt to managed care.
- The transition necessitates significant changes in healthcare delivery methods for providers.