Dataset Information

How does Medicaid-managed care impact reporting of Medicaid status?

ABSTRACT:

Objective

To resolve a conflict in the literature on whether Medicaid-Managed Care (MMC) impacts the Medicaid Undercount.

Data sources/study setting

California county-level data (1995-1997) on MMC penetration, public use data from the Current Population Survey (CPS) (1995-1997), and restricted CPS data matched to administrative records on Medicaid enrollment (2001-2002).

Study design

We explore the robustness of previous results from the literature first using aggregate data and alternative models. We then examine CPS data linked to Medicaid enrollment data to estimate models of Medicaid reporting errors related to MMC.

Data collection/extraction methods

The Census Bureau linked administrative data on Medicaid enrollment to the CPS. Other data used were public use.

Principal findings

We find similar results to a previous study using aggregate data that suggest that MMC worsens reporting of Medicaid enrollment. However, using alternative methods we find those results are not statistically significant and can have opposite signs. Our linked CPS microdata analysis suggests that MMC improves reporting. The article concludes with implications of these results for policy makers.

Conclusion

It is unlikely that increased MMC penetration explains the increased Medicaid Undercount.

SUBMITTER: Plotzke MR

PROVIDER: S-EPMC2965506 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

How does Medicaid-managed care impact reporting of Medicaid status?

Plotzke Michael R MR Klerman Jacob Alex JA Davern Michael M

Health services research 20101001 5 Pt 1

<h4>Objective</h4>To resolve a conflict in the literature on whether Medicaid-Managed Care (MMC) impacts the Medicaid Undercount.<h4>Data sources/study setting</h4>California county-level data (1995-1997) on MMC penetration, public use data from the Current Population Survey (CPS) (1995-1997), and restricted CPS data matched to administrative records on Medicaid enrollment (2001-2002).<h4>Study design</h4>We explore the robustness of previous results from the literature first using aggregate dat ...[more]

PMID: 20609016

Similar Datasets

Project description:Background:Hyperkalemia, defined as a serum potassium level >5 mEq/L that results from multiple mechanisms, is a serious medical condition that can lead to life-threatening arrhythmias and sudden cardiac death. The coexistence of cardiac and renal diseases (ie, cardiorenal syndrome) significantly increases the complexity of care, but its economic impact is not well-characterized in this understudied Medicaid managed care population with hyperkalemia. Objective:To calculate the economic impact of hyperkalemia on patients with cardiorenal syndrome in a Medicaid managed care population in the United States using real-world data. Methods:In this retrospective cohort study, we used a proprietary Medicaid managed care database from 1 southern state. The total study population included 3563 patients, including 973 patients with hyperkalemia and 2590 controls (without hyperkalemia), who were matched based on age, comorbidities, and Medicaid eligibility status and duration, during a 30-month period between 2013 and 2016. The inclusion criteria for the hyperkalemia cohort were age ?18 years, Medicaid-only insurance status, coded cardiorenal diagnosis, and a claim for hyperkalemia during the study period. The cost was determined using paid claims data. Results:The mean healthcare costs (medical and pharmacy per member per year [PMPY] for patients with hyperkalemia was higher than that for the control cohort without hyperkalemia ($56,002 vs $23,653, respectively). These cost differences were driven by medical costs accrued in the hyperkalemia and in the control cohorts ($49,648 and $18,399 PMPY, respectively). Two of the largest drivers of the medical cost variance were inpatient costs ($33,116 vs $10,629 PMPY for the hyperkalemia and control cohorts, respectively) and dialysis costs ($2716 vs $810 PMPY, respectively). The medical loss ratios were 552% for the hyperkalemia cohort and 260% for the control cohort. Both cohorts had revenue deficits to the health plan, but the hyperkalemia cohort had double the medical loss ratio compared with the control cohort. Conclusions:The findings from this Medicaid managed care population suggest that hyperkalemia increases healthcare utilization and costs, which were primarily driven by the costs associated with inpatient care and dialysis. Our findings demonstrate that the Medicaid beneficiaries who have cardiorenal comorbidities accrue high costs to the Medicaid health plan, and these costs are even higher if a hyperkalemia diagnosis is present. The very high medical loss ratio for the hyperkalemia cohort in our analysis indicates that enhanced monitoring and management of patients with hyperkalemia should be considered.

Dataset Information

How does Medicaid-managed care impact reporting of Medicaid status?

Objective

Data sources/study setting

Study design

Data collection/extraction methods

Principal findings

Conclusion

Publications

How does Medicaid-managed care impact reporting of Medicaid status?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets