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Changes in health plans serving Medicaid, 1993-1996
1Mathematica Policy Research, Inc. (MPR), Washington, D.C., USA.
Health Affairs (Project Hope)
|October 7, 1997
Summary
Medicaid managed care plans increasingly serve Medicaid enrollees, with many plans heavily reliant on Medicaid. The number of Medicaid-only plans has doubled, and new commercial plans are entering the market.
Area of Science:
- Health Services Research
- Health Policy
- Managed Care
Background:
- The Medicaid managed care market underwent significant transformation between 1993 and 1996.
- Understanding the dynamics of health maintenance organization (HMO) participation in Medicaid is crucial.
Purpose of the Study:
- To analyze Medicaid enrollment trends within full-risk health plans.
- To examine the characteristics of plans serving Medicaid beneficiaries during a period of market change.
Main Methods:
- Development of a novel dataset linking Medicaid enrollment data with HMO industry data.
- Analysis of enrollment patterns and plan types between 1993 and 1996.
Main Results:
- Nearly 50% of Medicaid enrollees in capitated arrangements were in plans with at least 75% Medicaid enrollment.
- The count of Medicaid-only plans more than doubled from 1993 to 1996.
- While commercial plans increased Medicaid participation, over half of entering plans were newly established.
Conclusions:
- Medicaid managed care is increasingly concentrated in specialized or newly formed plans.
- The market shows a trend towards plans with high Medicaid dependency and the emergence of new entities.