Managing medicaid managed care: Are states becoming prudent purchasers? The hard reality of what it takes for states to take on the prudent-purchasing role, as seen in a five-state study.

This paper examines the extent to which five states are becoming "prudent p urchasers" in their oversight of Medicaid managed care. Our conclusions are mixed. These states are making more sustained efforts along these lines th an most private purchasers are and have improved the amount and quality of the data they collect on the experiences of Medicaid clients when compared with the traditional fee-for-service program. They have been less successfu l in ensuring data quality that is adequate to support contracting decision s and in developing the analytical or political capacity to use data to "ma nage" the managed care system. Becoming a prudent purchaser appears to be a complex task for states that may prove difficult to achieve.