Cover image for Medicaid reform and the American States : case studies on the politics of managed care
Medicaid reform and the American States : case studies on the politics of managed care
Daniels, Mark Ross, 1952-
Publication Information:
Westport, Conn. : Auburn House, 1998.
Physical Description:
xii, 308 pages : illustrations ; 24 cm
Format :


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RA412.5.U6 M427 1998 Adult Non-Fiction Central Closed Stacks

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Medicaid is the primary means for providing medical care to the nation's indigent and disabled populations. Almost 13 percent of all Americans received some form of medical coverage, such as physician services or long-term care, through Medicaid in the early 1990s. The costs continue to rise dramatically, and state governments have become alarmed by the growing share of their budgets that Medicaid consumes.

Daniels and his contributors present the efforts of 16 states to reform their Medicaid programs through a system of managed care--programs that seek to control or manage the use by patients of physicians and other heath care services. They present an overview of the inconsistency and paradox of American health care, pointing to the ways each state's unique political and economic variables give rise to individually stylized approaches to the delivery of Medicaid services. The most comprehensive look at state efforts in Medicaid reform, the book will be an invaluable resource for scholars and researchers in the fields of public and health administration, for practitioners, and for policymakers.

Author Notes

MARK R. DANIELS is Associate Professor of Government and Public Affairs at Slippery Rock University at Pennsylvania and Coordinator of the Master of Public Administration degree program. He has published articles on Medicaid reform and is the author of Terminating Public Programs, Policies and Organization: An American Political Paradox .

Reviews 1

Choice Review

This book examines the efforts of 16 state Medicaid programs to use managed care as a health care delivery system that increases quality while controlling costs (Alabama, Arizona, California, Delaware, Florida, Kansas, Maryland, Michigan, New York, Ohio, Oklahoma, Oregon, South Dakota, Tennessee, Texas, West Virginia). These Medicaid program efforts are focused on the gatekeeper approach of primary care case management (PCCM). Chapter authors conclude that these states use PCCM primarily as a cost control effort, but that no evidence exists that convincingly demonstrates costs are better controlled under managed care. They also find no convincing evidence that these managed care programs have improved the quality of care, and they call for states to design better systems to evaluate their managed care programs. Clear, well-written material. All levels. J. E. Allen; University of North Carolina at Chapel Hill

Table of Contents

Mark R. DanielsRene P. McEldowneyMichelle A. Saint-GermainPatricia A. WilsonEric D. Jacobson and Amy B. DroskoskiKhi V. Thai and Mary Ann FeldheimJocelyn M. Johnston and Raymond G. Davis and Michael H. FoxThomas R. Oliver and Karen Anderson OliverMichael Harris and Rhonda S. KinneyKent Gardner and David BondJames Boex and Laura C. Yancer and Terry F. BussWilliam Parle and Ron WoosleyLeonard H. Friedman and Brenda GoldsteinDavid L. AronsonMark R. DanielsCarol Waters and Aaron KnightL. Christopher Plein
Figures and Tablesp. ix
Prefacep. xi
1. Introduction: The Inconsistency and Paradox of American Health Carep. 1
2. The Alabama Medicaid Reform Planp. 13
3. Arizona Health Care Cost Containment Systemp. 28
4. Managed Health Care in California: The Economic and Political Issues and the Strategic Planp. 56
5. The Diamond State Health Plan: Delaware's Experience with Medicaid Managed Carep. 66
6. Medicaid in a Managed Care Environment: The Florida Experiencep. 92
7. Medicaid Reform in Kansas: A Cautious Approachp. 110
8. Managed Care or Managed Politics? Medicaid Reforms in Marylandp. 135
9. Economic Constraints and Political Entrepreneurship: Medicaid and Managed Care in Michiganp. 169
10. New York: Medicaid Managed Care in the Empire Statep. 186
11. OhioCare: The Waiver That Wasn'tp. 202
12. SoonerCare: Reforming Medicaid with Managed Care Oklahoma Stylep. 213
13. Medicaid Reform in Oregon: A Case of Intellectual Honestyp. 226
14. Medicaid Reform in South Dakota: Managed Care in a Rural Environmentp. 241
15. Medicaid Reform from the Executive Branch: Tennessee's TennCare Programp. 251
16. Medicaid Reform in the Lone Star State: State of Texas Access Reform Starp. 261
17. Uncertain Prospects: West Virginia and Medicaid Reformp. 275
Selected Bibliographyp. 293
Indexp. 299
About the Contributorsp. 303