Related Experiment Videos
Provider risk sharing in Medicaid managed care plans
Debra A Draper1, Marsha R Gold
1Mathematica Policy Research, Washington, DC, USA.
Health Affairs (Project Hope)
|May 22, 2003
Summary
Medicaid managed care plans commonly use provider risk-sharing arrangements, often with traditional providers. This contrasts with trends in other insurance lines, suggesting Medicaid may not follow the "flight from risk."
Area of Science:
- Health Services Research
- Healthcare Management
- Public Health Policy
Background:
- Provider risk-sharing arrangements were prevalent in the 1990s.
- Recent trends indicate a potential decline in interest for risk-sharing.
- Specific data on Medicaid managed care risk-sharing was lacking.
Purpose of the Study:
- To examine the prevalence and nature of risk-sharing arrangements in Medicaid managed care.
- To assess if Medicaid plans are experiencing a
- flight from risk
- similar to other healthcare sectors.
Main Methods:
- A survey of Medicaid managed care plans was conducted in eleven states during 2001.
- Data collected focused on the types and extent of provider risk-sharing agreements.
Main Results:
- Risk-sharing arrangements are prevalent among Medicaid-participating managed care plans.
- These arrangements frequently involve traditional healthcare providers.
- Evidence of a
- flight from risk
- was not apparent in the surveyed Medicaid plans.
Conclusions:
- Risk-sharing remains a common strategy within Medicaid managed care.
- Medicaid's unique characteristics may insulate it from broader market trends like the
- flight from risk
- .