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The impact of managed care enrollment on emergency department use among children with special health care needs.
Med Care. 2007 Feb; 45(2):139-45.MC

Abstract

BACKGROUND

Many states recently have experimented with managed care as a way both to control costs and to enhance continuity of care in their publicly financed programs. A few states have applied managed care models to the care of chronically ill children. One marker for the effects of managed care is changes in use of the emergency department (ED).

OBJECTIVE

We sought to determine whether a managed care program can reduce ED use for children with chronic health problems.

SUBJECTS

We studied chronically ill children who were dually enrolled in Michigan's Title V program for children with special health care needs and Medicaid and who were enrolled in a managed care option at some time during the study period. The managed care model emphasized care coordination and did not include strong financial incentives for utilization and cost control. Sample consisted of 8580 person-months.

METHOD

We used a fixed-effect negative binomial Poisson regression model to compare ED use before and after joining a managed care plan to test whether managed care use was associated with reduced likelihood of ED use.

RESULTS

Managed care enrollment was associated with a 23% reduction in the incidence of ED use among children dually enrolled in Medicaid and Title V.

CONCLUSIONS

A managed care model is associated with statistically significant and substantive reductions in observed use of ED care within an important population of children facing chronic illness.

Authors+Show Affiliations

University of Chicago School of Social Service Administration, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17224776

Citation

Pollack, Harold A., et al. "The Impact of Managed Care Enrollment On Emergency Department Use Among Children With Special Health Care Needs." Medical Care, vol. 45, no. 2, 2007, pp. 139-45.
Pollack HA, Wheeler JR, Cowan A, et al. The impact of managed care enrollment on emergency department use among children with special health care needs. Med Care. 2007;45(2):139-45.
Pollack, H. A., Wheeler, J. R., Cowan, A., & Freed, G. L. (2007). The impact of managed care enrollment on emergency department use among children with special health care needs. Medical Care, 45(2), 139-45.
Pollack HA, et al. The Impact of Managed Care Enrollment On Emergency Department Use Among Children With Special Health Care Needs. Med Care. 2007;45(2):139-45. PubMed PMID: 17224776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of managed care enrollment on emergency department use among children with special health care needs. AU - Pollack,Harold A, AU - Wheeler,John R C, AU - Cowan,Anne, AU - Freed,Gary L, PY - 2007/1/17/pubmed PY - 2007/3/9/medline PY - 2007/1/17/entrez SP - 139 EP - 45 JF - Medical care JO - Med Care VL - 45 IS - 2 N2 - BACKGROUND: Many states recently have experimented with managed care as a way both to control costs and to enhance continuity of care in their publicly financed programs. A few states have applied managed care models to the care of chronically ill children. One marker for the effects of managed care is changes in use of the emergency department (ED). OBJECTIVE: We sought to determine whether a managed care program can reduce ED use for children with chronic health problems. SUBJECTS: We studied chronically ill children who were dually enrolled in Michigan's Title V program for children with special health care needs and Medicaid and who were enrolled in a managed care option at some time during the study period. The managed care model emphasized care coordination and did not include strong financial incentives for utilization and cost control. Sample consisted of 8580 person-months. METHOD: We used a fixed-effect negative binomial Poisson regression model to compare ED use before and after joining a managed care plan to test whether managed care use was associated with reduced likelihood of ED use. RESULTS: Managed care enrollment was associated with a 23% reduction in the incidence of ED use among children dually enrolled in Medicaid and Title V. CONCLUSIONS: A managed care model is associated with statistically significant and substantive reductions in observed use of ED care within an important population of children facing chronic illness. SN - 0025-7079 UR - https://www.unboundmedicine.com/medline/citation/17224776/The_impact_of_managed_care_enrollment_on_emergency_department_use_among_children_with_special_health_care_needs_ L2 - https://doi.org/10.1097/01.mlr.0000250257.26093.f0 DB - PRIME DP - Unbound Medicine ER -