Social and Behavioral Sciences Commons^™

A Tale Of Two Cities? The Heterogeneous Impact Of Medicaid Managed Care, James Marton, Aaron Yelowitz, Jeffrey Talbert

Aaron Yelowitz

Evaluating Accountable Care Organizations is difficult because there is a great deal of heterogeneity in terms of their reimbursement incentives and other programmatic features. We examine how variation in reimbursement incentives and administration among two Medicaid managed care plans impacts utilization and spending. We use a quasi-experimental approach exploiting the timing and county-specific implementation of Medicaid managed care mandates in two contiguous regions of Kentucky. We find large differences in the relative success of each plan in reducing utilization and spending that are likely driven by important differences in plan design. The plan that capitated primary care physicians and contracted …