Racial disparities in service use among medicaid beneficiaries after mandatory enrollment in managed care: A difference-in-differences approach

Managed care may improve access to health care to previously underserved po pulations when providers need plan enrollees. However capitation and utiliz ation management often give providers the incentive to withhold care. Manag ed care organizations have yet to demonstrate that racial disparities in tr eatment ave not exacerbated Using Medicaid eligibility, claims, and managed care encounter data, we examine racial disparities in service use among Me dicaid beneficiaries after mandatory enrollment in managed care. We use cou nt data models adjusted for nonrandom selection within difference-in-differ ences econometric approaches. The results show that mandatory enrollment ha s disproportionately reduced the relative use of physician and inpatient se rvices among African-American beneficiaries.