Perils of pioneering: Monitoring Medicaid managed care.
Date of Pub
Hoag, Sheila D
This article reviews Federal and State oversight of Section 1115 Medicaid managed care demonstrations in Hawaii, Oklahoma,
Rhode Island, and Tennessee from 1994 to 1998. Under Medicaid managed care, the Federal Government and States have had to
shift their focus and resources into oversight functions that barely existed in fee-for-service (FFS) Medicaid. We find that
Medicaid monitoring was slow to begin and not always adequate in these demonstrations. While State and Federal monitoring
have improved over time, monitoring is not yet at the point of ensuring access and quality.
Eligibility Determination : Hawaii : Health Care Reform : Health Maintenance Organizations : Health Policy/economics : Health
Services Accessibility : Managed Care Programs : Oklahoma : Program Evaluation/statistics & numerical data : Quality Assurance,
Health Care : Rhode Island : State Health Plans : Support, U.S. Gov't, Non-P.H.S. : Tennessee : United States Health Care