Medicaid managed care: contribution to issues of health reform

This chapter examines the emergence of managed care in Medicaid from an alternative to the mainstream delivery system for many beneficiaries. It offers a definition that encompasses the broad spectrum of program manifestations, and presents a brief historical perspective on the major eras of managed care in Medicaid. The major program prototypes are described and their contribution to enrollment growth is discussed. Research evidence is examined to address both operational issues and program impacts. Finally, we conclude with an appraisal of contemporary issues of importance and speculation on the next generation of Medicaid managed care programs with an eye to how federal and state health care reform proposals will shape this future.