Outsourcing administrative functions: service organization demonstrations and Florida Medicaid PCCM program costs.
This study examines the cost implications of outsourcing Medicaid functions to the private sector. We examine the expenditures for enrollees in three Medicaid primary care case management (PCCM) demonstration projects compared to Florida's PCCM program from February 2002-February 2003. The RAND two-part model was used to analyze the medica expenditures for enrollees in each program. After adjusting for sociodemographic factors and the probability of service use, we found that all three demonstration projects reduced expenditures compared to the PCCM program. The implications from the study are that Medicaid programs may want to consider outsourcing PCCM functions after further studies examine the utilization experience for enrollees in these programs.
Department of Health Policy and Management, School of Rural Public Health, Texas A&M University System Health Sciences Center, Bryan, Texas, USA. cejohnson@srph.tamhsc.edu
Christopher E
CE
Johnson
Christy Harris
CH
Lemak
Allyson G
AG
Hall
Jeffrey S
JS
Harman
Jianyi
J
Zhang
R Paul
RP
Duncan
D000293:Adolescent; D000328:Adult; D019090:Case Management / Q000458:organization & administration*; D005431:Florida; D006801:Humans; D008484:Medicaid; D008875:Middle Aged; D008962:Models, Theoretical; D016017:Odds Ratio; D019982:Organizational Case Studies; D020416:Outsourced Services / Q000458:organization & administration*; D011320:Primary Health Care; D014481:United States; D055815:Young Adult