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Partially capitated managed care versus FFS for special needs children.

Cynthia R Schuster1, Jean M Mitchell, Darrell J Gaskin

  • 1The RAND Corporation, USA.

Health Care Financing Review
|August 29, 2007
PubMed
Summary

Medicaid managed care plans with case management improve access to essential therapies for children with special health care needs. Children in these plans receive more school-based occupational and physical therapy compared to fee-for-service.

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Last Updated: Jul 12, 2026

Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery
04:36

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Published on: April 14, 2026

Area of Science:

  • Health Services Research
  • Pediatric Health Policy
  • Managed Care Effectiveness

Background:

  • Limited research exists on the effectiveness of Medicaid managed care plans (MCPs) with case management for coordinating services for children with special health care needs (CSHCN).
  • Understanding service utilization patterns is crucial for optimizing care delivery for CSHCN.
  • The role of case management within MCPs in facilitating access to therapeutic services requires further investigation.

Purpose of the Study:

  • To evaluate the impact of enrolling CSHCN in a partially capitated MCP with case management versus a fee-for-service (FFS) model.
  • To compare the utilization of speech, occupational, and physical therapy services based on the site of service (school vs. health care sector).
  • To identify potential disparities in therapeutic service access between different Medicaid coverage models.

Main Methods:

  • Comparative analysis of therapeutic service utilization among CSHCN enrolled in a partially capitated MCP with case management and those in a FFS plan.
  • Examination of service use by specific therapy type (speech, occupational, physical) and by service delivery sector (school-based vs. health care sector).
  • Statistical comparison of service utilization rates between the two enrollment models.

Main Results:

  • Children with special health care needs enrolled in the partially capitated MCP were significantly more likely to receive occupational and physical therapy in the school setting compared to FFS enrollees.
  • Children enrolled in FFS were significantly less likely to be regular or frequent users of all examined therapeutic services compared to those in managed care.
  • Case management within the MCP appears to facilitate greater access to school-based therapeutic services for CSHCN.

Conclusions:

  • Partially capitated Medicaid managed care plans incorporating case management demonstrate effectiveness in coordinating and increasing the utilization of therapeutic services for CSHCN, particularly in school settings.
  • Enrollment in FFS plans is associated with reduced access to regular and frequent therapeutic services for CSHCN.
  • The findings underscore the importance of integrated case management within managed care for improving access to essential therapies for children with special health care needs.