CAPITATED MEDICAID AND THE PROCESS OF CARE OF ELDERLY HYPERTENSIVES AND DIABETICS - RESULTS FROM A RANDOMIZED TRIAL

PURPOSE: To measure the quality of care for hypertensive and diabetic elderly Medicaid beneficiari es enrolled in managed care versus fee-fo r-service (FFS) plans. METHODS: Individuals enrolled in the Medicaid D emonstration project in Hennepin County, Minnesota, were randomly assi gned to receive their care either in one of seven managed care health plans in which the Medicaid payment for their cave was capitated or in an FFS plan. Two hundred ninety-one hypertensives and 96 diabetics wh o were aged 65 years or over at the beginning of the evaluation were i nterviewed at baseline and followed for 1 year. Drug and nondrug thera py, monitoring, monthly medication costs, and access to medications we re assessed. RESULTS: The prepaid and FFS did not differ in drug or no ndrug therapy, with the exception that slightly more FFS enrollees wer e on human insulin after 1 year. Mean monthly medication costs and acc ess to medications were similar for both groups. CONCLUSIONS: In this randomized trial, we were unable to detect differences in the process of care for hypertensive and diabetic Medicaid enrollees.