A State Comparison to Understand Medicaid Delivery System Effects on Access and Use of Preventative Services

Abstract

Since the mid-1980s, states have employed managed care organizations (MCOs) as a delivery system to coordinate the receipt of healthcare services for Medicaid beneficiaries. Though privatizing the delivery of Medicaid services can provide states more predictability in program costs, there is concern that the care delivered or facilitated by MCOs may not ensure beneficiaries receive the healthcare they need. The existing literature on this topic shows consistently mixed results on beneficiary access to care and the quality of the care received. This thesis uses the 2014 Behavioral Risk Factor Surveillance System survey to evaluate access to medical care and utilization of preventive healthcare by comparing responses between managed care states and non-managed care states. This thesis finds that there is not a consistent statistically significant difference in access and utilization in states with Medicaid managed care when compared to those without managed care. The absence of a consistent and meaningful difference resonates with much of the literature and affirms that more research is needed on this topic.