MEDICAID MANAGED CARE IN TEXAS - WHAT HAVE WE LEARNED FROM THE PILOTS

Texas has a plan for statewide implementation of Medicaid managed care by 2001. This article presents evidence from initial demonstration pr ojects, which were implemented in 1993. The Ist-year experience is des cribed and preliminary effects are examined in terms of reactions of c lients and providers and changes in utilization patterns and costs of care. Results of the evaluation indicate implementation difficulties w ith several operational aspects of managed care, variable effects in t erms of client and provider reaction to the reform and little or no ch ange in utilization patterns, but significant cost-savings to the stat e Because of the implementation difficulties identified by the evaluat ion and the mired results regarding effects, further research is recom mended to determine the potential benefit of this reform.