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The complexities of managed care: operating a voluntary system.

J M Prottas, E Handler

    Journal of Health Politics, Policy and Law
    |January 1, 1987
    PubMed
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    Implementing state-sponsored case management for public assistance recipients presents unique recruitment challenges. These challenges stem from the program

    Area of Science:

    • Public Health Policy
    • Healthcare Management
    • Social Welfare Programs

    Background:

    • State-sponsored voluntary case management programs aim to assist public assistance recipients.
    • Implementation is influenced by unique state-specific economic, political, and historical factors.
    • The Massachusetts managed care program for Aid to Families with Dependent Children (AFDC) families serves as a case study.

    Purpose of the Study:

    • To examine factors influencing the operationalization of the Massachusetts managed care program.
    • To analyze provider recruitment and recipient enrollment issues.
    • To assess challenges in relation to program goals of cost containment and access.

    Main Methods:

    • Implementation study analyzing operationalization factors.

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  • Examination of provider recruitment and recipient enrollment.
  • Analysis of bureaucratic and operational problems faced by state Medicaid staff.

    • Main Results:

    • Unique provider and recipient recruitment problems arise from state-specific contexts.
    • Operational and bureaucratic challenges impact program maintenance.
    • Program goals of cost containment and access are central to enrollment and recruitment issues.

    Conclusions:

    • Administering such programs requires careful consideration of program goals and provider types.
    • Effective strategies for enrolling recipients in voluntary programs are crucial.
    • State-specific factors significantly influence the success of managed care implementation for public assistance recipients.