TY - JOUR
T1 - Does managed care widen infant health disparities? Evidence from Texas medicaid
AU - Kuziemko, Ilyana
AU - Meckel, Katherine
AU - Rossin-Slater, Maya
N1 - Publisher Copyright:
© 2018 American Economic Association.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects high- and low-cost infants (blacks and Hispanics, respectively). We find that black-Hispanic disparities widen-e.g., black mortality and preterm birth rates increase by 15 percent and 7 percent, respectively, while Hispanic mortality and preterm birth rates decrease by 22 percent and 7 percent, respectively. Our results are consistent with a risk-selection model whereby capitation incentivizes competing plans to offer better (worse) care to low- (high-) cost clients to retain (avoid) them in the future.
AB - Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects high- and low-cost infants (blacks and Hispanics, respectively). We find that black-Hispanic disparities widen-e.g., black mortality and preterm birth rates increase by 15 percent and 7 percent, respectively, while Hispanic mortality and preterm birth rates decrease by 22 percent and 7 percent, respectively. Our results are consistent with a risk-selection model whereby capitation incentivizes competing plans to offer better (worse) care to low- (high-) cost clients to retain (avoid) them in the future.
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U2 - 10.1257/pol.20150262
DO - 10.1257/pol.20150262
M3 - Article
AN - SCOPUS:85051020768
SN - 1945-7731
VL - 10
SP - 255
EP - 283
JO - American Economic Journal: Economic Policy
JF - American Economic Journal: Economic Policy
IS - 3
ER -