Impacts of Medicaid managed care on children

Objective. To assess the impact of switching from a fee-for-service (FFS) d elivery system to managed care on access to, use of, and satisfaction with health care for children. Data Sources/Study Setting. A 1998 survey of Medicaid recipients in rural M innesota. Study Design. Using a quasi-experimental framework, we compare the experien ces of children on Medicaid living in counties that had switched to managed care with those of children living in counties operating under FFS Medicai d. We address the impact of Medicaid managed care (MMC) on access to, use o f, and satisfaction with care. Data Collection Methods. A stratified random sample of children on Medicaid was drawn based on Medicaid enrollment files. Telephone interviews were co nducted with the child's parent or guardian between March and June 1998. An overall response rate of 70 percent was achieved, yielding a sample of 1,1 06 children (814 in MMC and 792 in Medicaid FFS). Principal Findings. We find very few significant differences in access to, use of, or satisfaction with health care services for children under MMC re lative to FFS. MMC did not change the patterns of health care service use o r the location at which care is delivered, two major goals of MMC initiativ es. Conclusions. Our results suggest that the Medicaid program's shift from FFS to managed care had little impact on the pattern of children's health care use, the location at which they obtained care, or the satisfaction with th e care they received.