Using MSIS Data to Analyze Medicaid Eligibility and Managed Care Enrollment Patterns in 1999. Tables 6A-6B: Medicaid Managed Care Enrollment by Plan Type and Age Group in December 1999

02/01/2003

While Tables 1-5 provided annual information for 1999, Tables 6-14 provide information from MSIS for a one month time period. By limiting the time period to one month, more detailed information from the MSIS data base can be used. Table 6A shows the number of Medicaid enrollees in each type of managed care plan by age group in December 1999. The count is duplicated since individuals could have been enrolled in more than one type of managed care plan, in which case, they would have been counted more than once. It is important to note that the working-age adult group (21 to 64 years) includes both disabled enrollees and adult enrollees who are parents, caretaker relatives or pregnant women. Table 6B converts the data in Table 6A to a percent distribution by age cohort; percentages reflect the duplicated counts in Table 6A.

National data on Medicaid managed care participation by age cohort have not been available before. Thus, in the past, it was not possible to determine the extent to which age groups, such as infants or the very old, were participating in various types of managed care plans.

Findings

  • In December 1999, the likelihood of being enrolled in any type of Medicaid managed care generally declined with age except for infants. About two-thirds of Medicaid children ages 1 to 15 were enrolled in some type of managed care. About 60 percent of infants were enrolled in some type of managed care, slightly below the rate for children in the 1-to-15-year-old group. The rate dropped to 56 percent for enrollees age 15 to 20. Just under half of working-age adults (age 21-64) were enrolled in some type of managed care plan. For persons age 65 or older, the likelihood of enrollment in a managed care plan was lower still and declined with age. Of those in the 65-to-74-year-old group, 33 percent were enrolled in some type of managed care, compared to 27 percent in the 75-to-84-year-old group and 21 percent of those over age 85.

  • For infants, children and working-age adults, the highest managed care participation rates were for HMOs, followed by PCCMs, dental plans, and BHPs. Medicaid enrollees age 65 or older were most likely to be enrolled in dental managed care plans, followed by HMOs and then BHPs. Only one to two percent of aged Medicaid enrollees were reported to be enrolled in PCCM plans.

  • Children were almost twice as likely as working-age adults to be enrolled in PCCM plans. However, most of the disabled individuals are included in the working-age adult population, so this may explain the difference.

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