How much is enough? An evidence-based framework for setting Medicaid payment rates

Article Abstract:

The practice of setting payment rates for Medicaid is analyzed and a new framework for determining Medicaid rates is developed. The framework is based on the beneficiary's perspective, that payment is adequacy is related to access to quality health care. The differences of the new framework with conventional practices and the theoretical ideal in payment setting are evaluated.

Commodity & service prices, Prices and rates, Company pricing policy

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Plan choice and changes in access to care over time for SSI-eligible children with disabilities

Article Abstract:

The effect of fee-for-service (FFS) and Medicaid managed care on poor children with disabilities is discussed. The effect of Medicaid managed care on the children is studied from the data that is provided by the caregivers of Supplemental Security Income (SSI)-eligible children with disabilities is discussed.

Management dynamics, Health aspects, Management, Disabled children, Company business management

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Premium increases in state health insurance programs: lessons from a case study of the Massachusetts Medicaid buy-in program

Article Abstract:

Comparison group methodology was used to determine the effect of a change in premium rate on health insurance disenrollment. The Massachusetts's CommonHealth-Working program, a state insurance policy, was considered for the study. Details of the Medicaid program and results of the case study are presented.

Massachusetts, Evaluation, Case study

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