Medicaid Managed Care in Florida and Racial and Ethnic Disparities in Preventable Emergency Department Visits.

Background: In an effort to address health care spending growth, coordinate care, and improve access to primary care in the Medicaid program, Florida implemented the Statewide Mandatory Managed Care (SMMC) program in May of 2014.Objectives: The objective of this study is to investigate the impact of...

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Publicado en:Medical Care Vol. 56; no. 6; pp. 477 - 484
Autores principales: Hu, Tianyan, Mortensen, Karoline, Chen, Jie
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Jun2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Lippincott Williams & Wilkins
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        atl: Medicaid Managed Care in Florida and Racial and Ethnic Disparities in Preventable Emergency Department Visits.
      aug:
        au:
          Hu, Tianyan
          Mortensen, Karoline
          Chen, Jie
        affil: Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
      sug:
        subj:
          Emergency Service Statistics and Numerical Data
          Quality of Health Care Statistics and Numerical Data
          Managed Care Programs Statistics and Numerical Data
          Health Services Accessibility Statistics and Numerical Data
          Healthcare Disparities Statistics and Numerical Data
          Minority Groups Statistics and Numerical Data
          Female
          Adult
          Insurance Coverage Statistics and Numerical Data
          Florida
          Middle Age
          Male
          Young Adult
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: In an effort to address health care spending growth, coordinate care, and improve access to primary care in the Medicaid program, Florida implemented the Statewide Mandatory Managed Care (SMMC) program in May of 2014.Objectives: The objective of this study is to investigate the impact of implementation of mandatory managed care in Medicaid on the preventable emergency department (ED) utilizations, with a focus on racial/ethnic minorities.Research Design: The primary data source is the universe of Florida ED visit and inpatient discharge data from 2010 to 2015, maintained by the Florida Agency for Health Care Administration. We adopt the New York University Billing's ED Classification Algorithm to create measures for preventable ED visits. Using difference-in-differences estimation, we examine preventable ED visits for Florida residents aged 18-64 with a primary payer of Medicaid (treatment group) and private health insurance (control group) pre-SMMC and post-SMMC reform.Results: Our findings show that SMMC is statistically significantly associated with more reductions in preventable ED visits among non-Hispanic African American (incidence rate ratio=0.81; 95% confidence interval, 0.70-0.94) and Hispanic (incidence rate ratio=0.72; 95% CI, 0.60-0.87) Medicaid enrollees relative to their white counterparts. We also find significant reduction of racial/ethnic disparities only in counties with above median preimplementation Medicaid managed care penetration rate.Conclusions: Our findings suggest that implementation of Medicaid mandatory managed care in Florida is associated with reduced racial/ethnic disparities in preventable ED visits.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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