Performance Improvement 2004. Using MSIS Data to Analyze Medicaid Eligibility and Managed Care Enrollment Patterns in 1999


In this report, the new MSIS enrollment data are utilized to provide detailed information on Medicaid eligibility patterns and managed care participation in calendar year 1999. A series of 14 tables were constructed for each of the 50 states and the District of Columbia, and then summarized at the national level. A separate File Listing gives the user the ability to go directly to the section or set of tables they are interested in. The data show that Medicaid eligibility and managed care enrollment vary dramatically across states. For example, Tennessee, for example, enrolled its entire Medicaid population in HMOs, while Alaska, Louisiana and Wyoming did not use any type of managed care for Medicaid enrollees in 1999. Overall, about 35 percent were enrolled in comprehensive managed care organizations (HMOs), and another 11 percent were enrolled in primary care case management (PCCM) plans. An additional 9 percent were enrolled in other types of prepaid health plans, such as behavioral health plans (BHPs) or dental plans, bringing the total enrollment in any kind of managed care plan to 55 percent. In terms of eligibility groups, about 69 percent of AFDC children (Section 1931) and 65 percent of AFDC adults (Section 1931) were either in an HMO or a PCCM, whereas only 33 percent of SSI disabled persons and 16 percent of SSI aged persons received care in that form.

PIC ID: 8012
Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy
Federal Contact: Drabek, John, 202-690-6443
Performer: Mathematica Policy Research, Inc., Plainsboro, NJ

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