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ACAP Resource Center

 Bibliography: Medicaid Managed Care

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Commonwealth Fund: "Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues." October 2011.Download
Commonwealth Fund: "Assessing the Financial Health of Medicaid Managed Care Plans and the Quality of Patient Care They Provide." September 2011.Download
Kaiser Commission on Medicaid and the Uninsured. "A Profile of Medicaid Managed Care Programs in 2010: Findings From a 50-State Survey." September 2011.Download
Lewin Group. “An Evaluation of Medicaid Savings from Pennsylvania's HealthChoices Program.” May 2011.Download
Sommers, B & Rosenbaum, R. "Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges." Health Affairs. February 2011.Download
Minnesota Department of Human Services. "Provider Payment and Reimbursement Rates," January 2011Download
Ingenix Consulting. "Health Benefit Exchange: Design Options for Safety Net Plans." November 2010.Download
Zelman, W. (State Coverage Initiative Project & Academy Health) "Community-Based Nonprofit Medicaid Plans and the New Health Insurance Exchanges: Opportunities and Challenges." October 2010. Download
ACAP. "How Safety Net Health Plans are Transforming Primary Care: Case Studies from the Field." August 3, 2010Download
Texas Association of Health Plans. "Expanding Medicaid Managed Care in Texas– The Right Dosage For Texas Recipients." May 2010. Download
Volk, Gwyn and Jaconbs, Anne. Implementing State Health Reform: Lessons for Policymakers. March 2010.Download
Eberly, T., Davidoff, A., and Miller, C. Managing the Gap: Evaluating the Impact of Medicaid Managed Care on Preventive Care Receipt by Child and Adolescent Minority Populations. Journal of Health Care for the Poor and Underserved 21 (2010): 92–111.Download
Kaiser Family Foundation. "Medicaid and Managed Care: Key Data, Trends, and Issues." February 2010Download
Finuf, Bob. (Children's Mercy FHP) "Comparison of Kansas & Oklahoma Medicaid Managed Care Market Conditions." January 4, 2010.Download
Finuf, Bob. (Children's Mercy FHP) "Medicaid Managed Care & CMFHP: A Proven Record of Providing Value." January 4, 2010. Download
United Hospital Fund. "The Big Picture: Private and Public Health Insurance Markets in New York." Fall 2009.Download
Kaiser Family Foundation. "Survey of Healthy San Francisco Participants." August 2009.Download
Lewin Group, ACAP, and MHPA. "Medicaid Non-Emergency Out-of-Network Payment Study." July 2009.Download
ACAP and The George Washington University. "Improving Medicaid’s Continuity and Quality of Care." July 2009.Download
Harman, J. & Duncan, P. (University of Florida) "An Analysis of Medicaid Expenditures Before and After Implementation of Florida's Medicaid Reform Pilot Demonstration." June 2009. Download
Coalition on New York State Public Health Plans, "Medicaid Managed Care & Family Health Plus Quality Update," May 2009.Download
California Program for Access to Care, "Understanding the Slow Growth in Medi-Cal and Healthy Families Premiums, 1999-2008," April 2009.Download
Lewin Group and AHIP, "Medicaid Managed Care Cost Savings - A Synthese of 24 Studies," March 2009.Download
Lewin Group and ACAP, "Analysis of Drug Rebate Equalization Act's Savings to the Medicaid Program," September 2008.Download
Lewin Group and ACAP, "Analysis of Dual Eligible Pharmacy Costs Under Medicaid and Medicare Part D," September 2008.Download
Christopher Trenholm, Embry Howell, Ian Hill, and Dana Hughes,"Three Independent Evaluations of Healthy Kids Programs Find Dramatic Gains in Well-Being of Children and Families," Mathematica In Brief #1; November 2007Download
Lewin Group and ACAP, Programmatic Assessment of Carve-In and Carve-Out Arrangements for Medicaid Prescription Drugs, October 24, 2007 Download
Lewin Group and ACAP, Medicaid Health Plans: A Turnkey Solution for Expanding Health Insurance Coverage Case Studies of California and Massachusetts, July 2007 Download
Cynthia R. Schuster, M.P.P., Jean M. Mitchell, Ph.D., and Darrell J. Gaskin, Ph.D., Partially Capitated Managed Care Versus FFS for Special Needs Children, Health Care Financing Review, Summer 2007,Volume 28, Number 4Download
Association for Community Affiliated Plans & National Association of Community Health Centers, The Impact of Community Health Centers & Community-Affiliated Health Plans on Emergency Department Use, April 2007.Download
Lewin Group with Association for Community Affiliated Plans and Medicaid Health Plans of America, Collaboration in Medicaid Managed Care Rate Setting, March 2007Download
Suzanne Felt-Lisk, M.P.A., Allison Barrett, and Rebecca Nyman, M.P.H., Public Reporting of Quality Information on Medicaid Health Plans, Spring 2007Download
Lewin Group, Assessment of HUSKY's, Connecticut's Medicaid Managed Care Program, January 17, 2007Download
Roohan, Patrick J. , MS, Jacqueline M. Butch, MBA, Joseph P. Anarella, MPH, "Quality Measurement in Medicaid Managed Care and Fee-for-Service: The New York State Experience." American Journal of Medical Quality, Volme 21, No 3, 185-191, December 2006.Download
Association for Community Affiliated Plans, Safety Net Health Plans: Critical Partners in the Health Care Safety Net --April 2006Download
Lewin Group, Medicaid Capitation Expansion's Potential Cost Savings, April 18, 2006Download
Lewin Group, Rate Setting and Actuarial Soundness in Medicaid Managed Care, January 23, 2006 Download
Disability Care Coordination Organizations, The Experience of Medicaid Managed Care Programs for People with Disabilities, Center for Health Care Strategies, 2006Download
Elaine Batchlor, Creating a Win-Win-Win With P4P, January, 2006Download
Schneider, Eric C., Alan M. Zaslavsky, Arnold M. Epstein, "Quality of care in for-profit and not-for-profit health plans enrolling Medicare beneficiaries." The American Journal of Medicine, Volume 118, Issue 12, pages 1392-1400, December 2005Download
Stephen Berman, Carl Armon, and James Todd, "Impact of a Decline in Colorado Medicaid Managed Care Enrollment on Access and Quality of Preventive Primary Care Services" PEDIATRICS December 1, 2005 Vol. 116 No. 6 December 2005, pp. 1474-1479 Download
Brodsky, Karen, "ACAP Best Practices in Specialty Provider Recruitment and Retention: A Report of Common Provider Network Challenges and the Actions Health Plans Have Taken to Address Them," funded by the Commonwealth FundDownload
National Academy of State Health Policy "Medicaid Managed Care: Looking Forward, Looking Back." June 2005Download
The Lewin Group, Assessment of Medicaid Managed Care Expansion Options in Illinois, May 2005Download
The Lewin Group and Coalition of Medical Assistance Managed Care Organizations, Comparative Evaluation of Pennsylvania’s HealthChoices Program and Fee-for-Service Program, May 2005Download
The Lewin Group, Comparative Evaluation of Pennsylvania's HealthChoices Program and Fee-for-Service Program, May 2005Download
Michigan Medicaid: Relative Cost Effectiveness of Alternative Service Delivery Models, University of Maryland, Center for Health Program Development and Management, April 2005Download
Mittler, J & Gold, M. Managed Care Quarterly. "Physician Participation in Medicaid Managed Care: The California Experience." Vol. 13 Num. 2 Pgs 1-11. Spring 2005.Download
Stankaitis JA, Brill HR, and Walker DM. “Reduction in Neonatal Intensive Care Unit Admission Rates in a Medicaid Managed Care Program.” The American Journal of Managed Care. March 2005Download
Innovations in Medicaid Managed Care. “Health Plan Programs to Improve the Health and Well-Being of Medicaid Beneficiaries.” America’s Health Insurance Plans. March 2005Download
Ann S. O'Malley, Christopher B. Forrrest, Robert M. Politzer, John T. Wulu and Leiyu Shi. "Health Center Trends, 1994-2001: What Do They Portend For The Federal Growth Initiative?" Health Affairs, Volume 24, Number 2, March/April 2005, 465-472.Download
Xiao X, Jensen GA. “Utilization of Health Care Services Among the Near-Elderly: A Comparison of Managed Care and Fee-for-Service Enrollees.” Managed Care Interface, March 2005Download
Chyongchiou Jeng Lin, Donald Musa; Myrna Silverman and Howard B. Degenholtz. "Do Managed Care Plans Reduce Racial Disparities in Preventive Care?" Journal of Health Care for the Poor and Underserved,February 2005Download
Bindman AB, Chattopadhyay A, Osmond DH, Huen W, Bacchetti P. "The impact of Medicaid managed care on hospitalizations for ambulatory care sensitive conditions." Health Serv Res. 2005 Feb; 40(1):19-38.Download
The Lewin Group. Business Opportunities in the Medicare Modernization Act for Medicaid Focused Plans, November 2004Download
Eric Schneider, Bruce Landon, Carol Tobias and Arnold M. Epstein. "Quality Oversight in Medicaid Primary Care Case Management Programs: As HMOs depart, are state Medicaid agencies ready to take the stage," Health Affairs, Volume 23, December 2004Download
James M. Guwani, Ph.D. and Robert Weech-Maldonado, M.B.A. "Medicaid Managed Care and Racial Disparities in AIDS Treatment." Health Care Financing Review. Winter 2004-2005/Volume 26, Number 2, 119-132. Download
United States Government Accountability Office. "Medicaid Managed Care: Access and Quality Requirements Specific to Low-Income and Other Special Needs Enrollees." Report to Senators, December 2004Download
Womeodu RJ, Graney MJ, Gibson DV, Bailey JE. “Diabetic Patient Experiences in a Medicaid Managed Care System.” Tennessee Medicine. 96(10): 465-9, 2004 Oct.Download
Jean M. Mitchell, PhD, and Darrell J. Gaskin, PhD. "Do Children Receiving Supplemental Security Income Who Are Enrolled in Medicaid Fare Better Under a Fee-for-Service or Comprehensive Capitation Model?," Pediatrics 2004; 114: 196-204, July, 2004.Download
Bruce E. Landon, Eric C. Schneider, Carol Tobias, and Arnold M. Epstein "The Evolution Of Quality Management In Medicaid Managed Care" Health Affairs, July/August 2004; 23(4): 245-254Download
The Lewin Group. "Medicaid Managed Care Cost Savings – A Synthesis of Fourteen Studies." Final Report Prepared for: America’s Health Insurance Plans, July 2004Download
The National Association for State Health Policy, State Budget Cuts and Medicaid Managed Care: Case Studies in Four States, June 2004Download
The Lewin Group, Opportunities and Observations for Indiana Medicaid, June 2004Download
Verdier JM, Hurley RE. “State Medicaid Managed Care Evaluations and Reports, Themes, Variations and Lessons.” Resource Paper. Center for Health Care Strategies. May 2004Download
Teresa A. Coughlin, Brian K. Bruen, and Jennifer King "States’ Use Of Medicaid UPL And DSH Financing Mechanisms" Health Affairs, March/April 2004; 23(2): 245-257.Download
Debra A. Draper, Robert E. Hurley, and Ashley C. Short "Medicaid Managed Care: The Last Bastion Of The HMO?" Health Affairs, March/April 2004; 23(2): 155-167.Download
Andrew B. Bindman, Arpita Chattopadhyay, Dennis H. Osmond, William Huen, and Peter Bacchetti. "The Impact of Medicaid Managed Care on Hospitalizations for Ambulatory Care Sensitive Conditions." Health Services Research, Feb 2004Download
McCue, Michael and Robert Hurley, "Financial Performance Indicators for Health Plans in Medicaid Managed Care", Managed Care Quarterly, 12(1), 2004, p. 20.Download
Manatt, Phelps & Phillips, LLP. “Medicaid Managed Care in New York: A Public-Private Partnership That Works.” A report of the New York State Coalition of Prepaid Health Services Plans. December 2003Download
Hurley, Robert and Michael McCue, "Profiting from Proficiency: The Growing Importance of Medicaid-Focused Health Plans," Center for Health Care Strategies, November 2003Download
Chang, Debbie, Alice Burton, John O'Brien, and Robert E. Hurley. Honesty As Good Policy: Evaluating Maryland's Medicaid Managed Care Program. The Milbank Quarterly, Vol. 81, No. 3, 2003.Download
The Alliance of Community Health Plans (ACHP) and the Association for Community Affiliated Plans (ACAP). Promoting Disease Prevention in Health Plans: Information Systems and Technology Assessment, October 2003. Download
Shields AE, Comstock C, Finkelstein JA, and Weiss KB. “Comparing Asthma Care Provided to Medicaid-Enrolled Children in a Primary Care Case Manager Plan and a Staff Model HMO.” Ambulatory Pediatrics. Volume 3, Number 5. September – October 2003Download
United States Government Accountability Office. "Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened." June 2003Download
Robert E. Hurley. Medicaid-Focused Health Plans: A Community Health Conspiracy, June 2003Download
Smith V, Hamacher L. “The Good Olde Days of Fee-for-Service Were Not So Good After All: Managed Care Has Made Things Better.” Health Management Associates for the Association of Health Center Affiliated Health Plans. May 2003Download
The Lewin Group. Extending the Federal Drug Rebate to Medicaid MCOs: Analysis of Impacts, May 2003Download
Debra A Draper and Marsha R Gold. "Provider risk sharing in Medicaid managed care plans" Health Affairs, May/June 2003; 22(3): 159-167Download
Marsha Gold, Jessica Mittler, Debra Draper, and David Rousseau "Participation of plans and providers in Medicaid and SCHIP managed care. State Children's Health Insurance Program" Health Affairs, January/February 2003; 22(1): 230-240Download
John Holahan and Shinobu Suzuki "Medicaid managed care payment methods and capitation rates in 2001" Health Affairs, January/February 2003; 22(1): 204-218.Download
Robert E Hurley and Stephen A Somers. "Medicaid and managed care: a lasting relationship?" Health Affairs, January/February 2003; 22(1): 77-88Download
Nancy Beronja, Joel Menges and Meg Murray. Comparison of Medicaid Pharmacy Costs and Usage between the Fee-for-Service and Capitated Settings, January 2003Download
American Journal of Public Health. "Provision of Sexual Health Services to Adolescent Enrollees in Medicaid Managed Care." Vol 92, No. 11, Pgs. 1779-1783.Download
Sparer, M., Brown, L., Gusmano, M., Rowe, C., and Gray, B. "Promising Practices: How Leading Safety-Net Plans are Managing the Care of Medicaid Clients." Health Affairs. 21 No. 5 (2002): 284-291Download
Schaller Anderson, Inc."Serving the Special Program/Aged, Blind, and Disabled Population through Managed Care" Center for Health Care Strategies, Inc. April 2002.Download
Barclay, Timothy. (Milliman) "Wisconsin HMOs' Success in Medicaid and BadgerCare: Government Cost Savings and Better Health Care Quality." February 22, 2002Download
Suzanne Felt-Lisk, Rebecca Dodge, and Megan McHugh, "Trends in Health Plans Serving Medicaid: 2000 The Henry J. Kaiser Family Foundation, November 2001, Document No. PR01-83, 44 PagesDownload
Sparer, M., and Brown, L. "Uneasy alliances: managed care plans formed by safety-net providers." Health Affairs. 19 No. 4 (September/October 2000): 23-35Download
Bindman AB, Grumbach K, Bernheim S, Vranizan K, Cousineau M. "Medicaid managed care's impact on safety-net clinics in California." Health Aff (Millwood). 2000 Jan-Feb;19(1):194-202.Download
American Journal of Public Health. "The effect of a Medicaid managed care program on the adequacy of prenatal care utilization in Rhode Island." Vol. 89, Issue 4 497-501.Download
Gray, BH and Rowe, C. "Safety-nethealth plans: a status report." Health Affairs. 19 No 1 (January/February 2000): 185-193Download