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Effect of managed care on Medicaid spending / Victoria Perez.

LIBRA HB004 2015 .P4381
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Format:
Book
Manuscript
Thesis/Dissertation
Author/Creator:
Pérez, Victoria (Victoria E.), author.
Contributor:
Pauly, Mark V., 1941- degree supervisor, degree committee member.
Duggan, Mark, degree committee member.
David, Guy, degree committee member.
Polsky, Daniel, degree committee member.
University of Pennsylvania. Department of Managerial Science and Applied Economics, degree granting institution.
Language:
English
Subjects (All):
Penn dissertations--Health care management.
Penn dissertations--Managerial science and applied economics.
Health care management--Penn dissertations.
Managerial science and applied economics--Penn dissertations.
Local Subjects:
Penn dissertations--Health care management.
Penn dissertations--Managerial science and applied economics.
Health care management--Penn dissertations.
Managerial science and applied economics--Penn dissertations.
Physical Description:
x, 95 leaves : illustrations ; 29 cm
Production:
[Philadelphia, Pennsylvania] : University of Pennsylvania, 2015.
Summary:
States choose to provide Medicaid coverage via managed care or traditional fee-for-service (FFS). Managed care provided by private insurers poses higher contracting costs and information asymmetry than traditional FFS, but potentially improves efficiency, reduces spending, and improves budget predictability. There is conflicting evidence about managed care savings for the Medicaid population. In this paper, I estimate the effect of Medicaid managed care on spending, coverage generosity, and budget predictability. I use measures of fiscal stress, political sentiment and electoral turnover as instruments for managed care enrollment. I find reductions in Medicaid spending larger than previously found in cross-state studies. These savings are not re-invested in Medicaid, suggesting there are non-financial constraints to Medicaid expansion. I also find that managed care is no more effective at reducing the occurrence of Medicaid deficits than other inter-temporal adjustments, such as physician payment freezes and reductions in eligibility.
Notes:
Ph. D. University of Pennsylvania 2015.
Department: Health Care Management, Managerial Science and Applied Economics.
Supervisor: Mark V. Pauly.
Includes bibliographical references.
OCLC:
950058407

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