Selection of prepaid or fee-for-service care by Medicaid families: examining the health-risk hypothesis.
These results indicate that one PHP, relative to the FFS system, experienced favorable selection on the part of Medicaid AFDC eligibles who have voluntarily enrolled in the plan. Moreover, they suggest the value of adding at least one simple health measure to Medicaid AFDC capitation formulae. The results regarding selection should be considered preliminary because they represent only one PHP-FFS comparison. Data from this PPMHC evaluation, as well as those from other ongoing comparative evaluations of Medicaid eligibles in prepaid and fee-for-service care (e.g., Freund et al., 1989), should provide considerably more information than is currently available on these issues, as well as on issues of the relative impact of PHP and FFS care on utilization and outcomes of Medicaid AFDC eligibles.
D002204:Capitation Fee; D002755:Choice Behavior; D003256:Community Participation / Q000523:psychology*; D003625:Data Collection; D005251:Fees, Medical; D005260:Female; D006304:Health Status; D006801:Humans; D007341:Insurance; D015273:Insurance Selection Bias; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration*; D015233:Models, Statistical; D015397:Program Evaluation; D012306:Risk; D014481:United States