Overview of Medicaid capitation and case-management initiatives.
Case-management programs have grown in number and in acceptance in the Medicaid program since 1981. In this article, we review their structure and incentives as well as what is known about their impact on cost and use. These programs also have been difficult to implement, posing myriad management challenges for prepaid program managers and State administrators. We highlight the problems in the following areas: eligibility, enrollment, rate setting, and management information systems.
D000368:Aged; D002204:Capitation Fee; D002755:Choice Behavior; D003625:Data Collection; D005249:Fees and Charges; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000458:organization & administration*; D009874:Operations Research; D014481:United States