Medicaid reform and the American States : case studies on the politics of managed care /

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