MEDICAID MANAGED CARE - CONTRIBUTION TO ISSUES OF HEALTH REFORM

This chapter examines the emergence of managed care in Medicaid from a n alternative to the mainstream delivery system for many beneficiaries . It offers a definition that encompasses the broad spectrum of progra m manifestations, and presents a brief historical perspective on the m ajor eras of managed care in Medicaid. The major program prototypes ar e described and their contribution to enrollment growth is discussed. Research evidence is examined to address both operational issues and p rogram impacts. Finally, we conclude with an appraisal of contemporary issues of importance and speculation on the next generation of Medica id managed care programs with an eye to how federal and state health c are reform proposals will shape this future.