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in Out of Sight, Out of Mind? Measuring the Relationship between Privatization and Medicaid Self-Reporting
> Journal of Health Politics, Policy and Law
Published: 01 April 2018
Figure A1 Medicaid Commercial MCO Penetration and Medicaid Reporting Rates
More
Image
in Out of Sight, Out of Mind? Measuring the Relationship between Privatization and Medicaid Self-Reporting
> Journal of Health Politics, Policy and Law
Published: 01 April 2018
Figure A2 Privately Named Medicaid MCO Penetration and Medicaid Reporting Rates
More
Journal Article
Cost-Effectiveness Analysis in the Courts: Recent Trends and Future Prospects
Available to Purchase
J Health Polit Policy Law (2001) 26 (2): 291–326.
Published: 01 April 2001
...Peter D. Jacobson; Matthew L. Kanna This article provides an initial look at how managed care organizations(MCOs) might incorporate cost-effectiveness analysis (CEA) into their decision-making process and how the courts might respond. Because so few medical liability cases directly involve CEA, we...
Journal Article
Can Public Policy Fix What Ails Managed Care?
Available to Purchase
J Health Polit Policy Law (1999) 24 (5): 1051–1060.
Published: 01 October 1999
... of managed care. Yet, real suf-
fering has occurred, and some of it is attributable to bad decisions made
by officials of managed care organizations (MCOs). But errors and
insensitivity to patients were part of the indemnity landscape as well, and
in spite of the publicity, there is no evidence...
Journal Article
Managed Care at the Millennium: Scenes from a Maul
Available to Purchase
J Health Polit Policy Law (1999) 24 (5): 1061–1070.
Published: 01 October 1999
... (e.g., mandatory external appeals, liability rights, and making
managed care organization [MCO] medical directors subject to the dis-
Journal of Health Politics, Policy and Law, Vol. 24, No. 5, October 1999. Copyright © 1999 by
Duke University Press.
1062 Journal of Health Politics, Policy...
Journal Article
Out of Sight, Out of Mind? Measuring the Relationship between Privatization and Medicaid Self-Reporting
Available to Purchase
J Health Polit Policy Law (2018) 43 (2): 137–183.
Published: 01 April 2018
...Figure A1 Medicaid Commercial MCO Penetration and Medicaid Reporting Rates ...
FIGURES
Journal Article
Addressing Social Determinants of Health through Medicaid: Lessons from Oregon
Available to Purchase
J Health Polit Policy Law (2019) 44 (6): 919–935.
Published: 01 December 2019
..., vulnerable population where SDOH are likely to be substantial factors in overall health. Second, state contracts with Medicaid managed care organizations (MCOs), which managed benefits for over two-thirds of Medicaid members as of 2016 (CMS 2018a ), create an opportunity for states to embed incentives...
Journal Article
Backlash: As Prelude to Managing Managed Care
Available to Purchase
J Health Polit Policy Law (1999) 24 (5): 1115–1126.
Published: 01 October 1999
... organizations (MCOs) and the private sector, so the
story goes, are not perfect, but the alternative—having legislatures man-
age health resources and bureaucracies make health care decisions—is
Funding provided by a Robert Wood Johnson Investigator award. Helpful comments were pro-
vided by Diane...
Journal Article
TennCare, One State's Experiment with Medicaid Expansion
Available to Purchase
J Health Polit Policy Law (2015) 40 (4): 933–936.
Published: 01 August 2015
... from these multiple perspectives, limiting the narrative to public officials, managed care organizations (MCOs), selected providers, and enrollee advocates. It is an innovative approach that yields a rich amount of information concerning the various groups. Bennett argues that these players, all...
Journal Article
Oregon's Experiment in Health Care Delivery and Payment Reform: Coordinated Care Organizations Replacing Managed Care
Available to Purchase
J Health Polit Policy Law (2015) 40 (1): 245–255.
Published: 01 February 2015
... capitated managed care organizations (MCOs) and outlines several implementation challenges the CCO model faces. In 2009 House Bill 2009 established the Oregon Health Authority (OHA) as an independent agency. It also established the Patient-Centered Primary Care Home (PCPCH) program, to promote...
FIGURES
Journal Article
Managed Care and Private Health Insurance in a Global Context
Available to Purchase
J Health Polit Policy Law (2008) 33 (6): 1107–1131.
Published: 01 December 2008
... (MCOs) were developed in the United States
several decades ago largely as a response to escalating health care costs.
Like “traditional” private health insurers of the 1960s and 1970s, most
Weiner et al. ■ Global Context of Managed Care, Private Insurance 1109
MCOs — such as health...
Journal Article
J Health Polit Policy Law (2015) 40 (1): 227–232.
Published: 01 February 2015
... care organization (MCO) that participates in Medicaid. ▪ Change in provider . This would occur when a person must change provider because his or her former provider is not in-network in the new program or carrier. This form of disruption, we should note, could occur even if the QHP and MCO are part...
Journal Article
The Medicaid Managed Care Policy Consensus for Welfare Recipients: A Reflection of Traditional Welfare Concerns
Available to Purchase
J Health Polit Policy Law (1997) 22 (3): 815–838.
Published: 01 June 1997
...; Congressional Research Ser-
vice 1993; Lewin–VHI 1995; Rowland et al. 1995). Under risk-based
capitation programs, states contract with managed care organizations
(MCOs)—which can include private health maintenance organizations
(HMOs) or prepaid health plans (PHPs) such as federally qualified health...
Journal Article
Political Strategies of Safety-Net Providers in Response to Medicaid Managed Care Reforms
Available to Purchase
J Health Polit Policy Law (2009) 34 (1): 5–35.
Published: 01 February 2009
... to contracting
with managed care organizations (MCOs). In Connecticut’s case, the
state actively recruited commercial MCOs to contract with the state to
provide services to Medicaid recipients. This changed the constellation
of actors in the policy network and traditional Medicaid safety-net pro-
viders...
Journal Article
Reading the Fine Print: State Considerations for Medicaid Buy-In Plans
Available to Purchase
J Health Polit Policy Law (2020) 45 (1): 153–164.
Published: 01 February 2020
... or a Medicaid Managed Care Organization (MCO), 3) who is eligible to purchase plans, and 4) which benefits and providers will be covered and at what payment rates. Our goal is to clarify the implications of these choices with respect to the aforementioned goals and with respect to the tradeoffs each choice...
Journal Article
The Paradoxical Politics of Provider Reempowerment
Available to Purchase
J Health Polit Policy Law (2004) 29 (6): 1045–1072.
Published: 01 December 2004
... organizations [HMOs] or managed care
organizations [MCOs These entities take responsibility for both financ-
ing and delivery of care; to do so at competitive prices, they must bring
Journal of Health Politics, Policy and Law, Vol. 29, No. 6, December 2004. Copyright © 2004 by
Duke University Press.
1046...
Journal Article
Iowa Wavering on Medicaid: From Expansion to Modernization
Available to Purchase
J Health Polit Policy Law (2016) 41 (2): 287–300.
Published: 01 April 2016
... and Reynolds 2014 ; Iowa Department of Human Services 2015d ). While the comprehensive nature of Iowa's Medicaid Modernization is unique among states, the program is generally consistent with national trends: as of 2014, thirty-nine states contracted with managed care organizations (MCOs) to provide...
Journal Article
The Resurgence of Selective Contracting Restrictions
Available to Purchase
J Health Polit Policy Law (1997) 22 (5): 1133–1189.
Published: 01 October 1997
... reduce patient access to providers, along with provider access to paying patients, so many providers have lobbied for AWP-FOC laws. In opposition are managed care organizations (MCOs), which want full freedom to contract selectively to control prices and utilization. This article comprehensively...
Journal Article
The Politics of Evidence-Based Medicine
Available to Purchase
J Health Polit Policy Law (2001) 26 (2): 439–446.
Published: 01 April 2001
...-
ically appropriate with little need to explain or justify their decisions.
Over the past quarter century, managed care organizations (MCOs)
have shifted power away from physicians to payers. MCOs required, in
one way or another, that doctors and medical...
Journal Article
Boutique to Booming: Medicare Managed Care and the Private Path to Policy Change
Available to Purchase
J Health Polit Policy Law (2016) 41 (3): 315–354.
Published: 01 June 2016
... annual growth rates, Democrats controlled the White House and both houses of Congress. When the Balanced Budget Act of 1997 (BBA) was enacted, legislation that was expected to significantly increase managed care organization (MCO) participation and beneficiary enrollment, it was passed on a remarkably...
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