Throughout the 1970s and into the early 1980s continuing efforts to control inflation in Medicaid expenditures led states to adopt stricter Medicaid eligibility standards, which in combination with a recession in the early 1980s left nearly 40 percent of the nation's poor without medical coverage. To prevent further restrictions in Medicaid access, the Robert Wood Johnson Foundation (RWJ) sponsored a demonstration project, the Program for Prepaid Managed Health Care (PPMHC) in the first half of the 1980s. This RAND Corporation report contains the design and results from the cost and utilization evaluation of the PPMHC.
These appendices accompany a report that evaluates alternative assessment tools for use in a prospective payment system (PPS) for inpatient rehabilitation facilities. They include samples of study forms and instructions; descriptions of measures; recruitment and participation letters; and more.
Although competition among health plans has been encouraged as a means to control health care expenditures, some fee-for-service (FFS) insurers attribute part of their increased average expenditures to favorable selection of low users into newly offered health maintenance organization (HMO) plans. To test this hypothesis, the health care expenditure patterns of approximately 30,000 employees in a large, multi-site aerospace firm were examined. FFS system expenditure patterns for people who joined HMOs were compared with those of people who remained in the FFS system. Information on socioeconomic status, plan choice, employee dependents, and filed claims were reviewed. The unit of observation was a family year of claimed expenditures. Expenditure data for families that switched between FFS and HMO plans between 1978 and 1982 were classified into four groups: (1) one year preHMO; (2) other years preHMO; (3) one year postHMO; and (4) other years postHMO. For families remaining in FFS plans, all years of data were "stayer" years. Family year expenditures were compared across these five groups. The results revealed that families selecting HMOs had lower mean expenditures than did families who remained in the FFS system. Families who left HMOs had higher mean expenditures than did those who entered HMOs. Some, but not all, of these differences were explained by family characteristics. (NB)
Thank you for visiting our website. Would you like to provide feedback on how we could improve your experience?
This site does not use any third party cookies with one exception — it uses cookies from Google to deliver its services and to analyze traffic.Learn More.