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Diane Publishing Books
Medicaid: Service Utilization Patterns for Beneficiaries in Managed Care
Carolyn L. Yocom (au)
Medicaid, a federal-state health financing program for low-income and medically needy individuals, covered 65 million beneficiaries at an estimated cost of $508 billion in FY 2014. More than half of Medicaid beneficiaries are enrolled in managed care plans, a health care delivery model where states contract with managed care organizations to provide covered services for a set cost. Historically, states have submitted relatively unreliable managed care service utilization data, also known as encounter data, to the Centers for Medicare & Medicaid Services (CMS). However, recent evidence suggests that encounter data may be improving. This report describes what encounter data indicate about the service utilization of Medicaid beneficiaries in managed care plans. Tables and figures. This is a print on demand report.
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