Public health departments adapt to Medicaid managed care

Millions of Medicaid beneficiaries have recently moved into private managed care plans across the country. Public health departments--which have acted as providers of primary care and other services for some Medicaid patients--are often not explicitly included in contracts between these designated Medicaid plans and the states. As a result, many of the 3,000 city and county public health agencies nationwide have lost both patients and significant revenue to plans. This Issue Brief describes how public health departments are adapting to this shift in state policy. According to our research conducted in 1997, many are de-emphasizing the delivery of direct health care services in favor of core public health functions, such as investigating community health problems and health promotion. Some are initiating new partnerships with Medicaid managed care plans.