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Medicaid managed care enrollments and potentially preventable admissions: An analysis of adult Medicaid recipients in Florida

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ABSTRACT This study examines the relationship between a managed care program and preventable hospitalization for Medicaid beneficiaries. Also, a theoretical framework of market competition is developed to examine the relationship… Click to show full abstract

ABSTRACT This study examines the relationship between a managed care program and preventable hospitalization for Medicaid beneficiaries. Also, a theoretical framework of market competition is developed to examine the relationship between the Medicaid managed care market and preventable hospitalization for overall Medicaid patients across all Medicaid payer groups. The data of the study were 1,957,072 Medicaid patients aged 18–64 years who were discharged from a short-term general hospital in Florida from 2006 to 2012. We used two-level hierarchal models to predict the probability of preventable hospitalization. The results show that Medicaid managed care patients had a higher probability of preventable hospitalization than Medicaid fee-for-service patients. This study also found that market competition moderates the relationship between Medicaid insurance type and preventable hospitalization.

Keywords: medicaid managed; preventable hospitalization; managed care; medicaid

Journal Title: International Journal of Healthcare Management
Year Published: 2019

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