Does managed care widen infant health disparities? Evidence from Texas medicaid

Ilyana Kuziemko, Katherine Meckel, Maya Rossin-Slater

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)255-283
Number of pages29
JournalAmerican Economic Journal: Economic Policy
Volume10
Issue number3
DOIs
StatePublished - Aug 1 2018

All Science Journal Classification (ASJC) codes

  • Economics, Econometrics and Finance(all)

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