Search

Medicaid managed care : efficiency, medical loss ratio, and quality of care

<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/MARC21/slim http://www.loc.gov/standards/marcxml/schema/MARC21slim.xsd">
  <record>
    <leader>00000cab a2200000   4500</leader>
    <controlfield tag="001">MAP20210010750</controlfield>
    <controlfield tag="003">MAP</controlfield>
    <controlfield tag="005">20210405172826.0</controlfield>
    <controlfield tag="008">210331e20210301esp|||p      |0|||b|spa d</controlfield>
    <datafield tag="040" ind1=" " ind2=" ">
      <subfield code="a">MAP</subfield>
      <subfield code="b">spa</subfield>
      <subfield code="d">MAP</subfield>
    </datafield>
    <datafield tag="084" ind1=" " ind2=" ">
      <subfield code="a">6</subfield>
    </datafield>
    <datafield tag="100" ind1="1" ind2=" ">
      <subfield code="0">MAPA20080260019</subfield>
      <subfield code="a">Brockett, Patrick L.</subfield>
    </datafield>
    <datafield tag="245" ind1="1" ind2="0">
      <subfield code="a">Medicaid managed care</subfield>
      <subfield code="b">: efficiency, medical loss ratio, and quality of care</subfield>
      <subfield code="c">Patrick Brockett. Linda Golden, Charles C. Yang & David Young</subfield>
    </datafield>
    <datafield tag="520" ind1=" " ind2=" ">
      <subfield code="a">The recent final rule on Medicaid managed care establishes the minimum medical loss ratio (MLR) requirement for Medicaid managed care and contains several provisions to strengthen delivery and payment reforms and improve efficiency and quality of care. Accordingly, this research examines the quality of Medicaid managed care and the effect of MLR and efficiency. The results show that, medical services efficiency has an insignificant (but negative) effect on the quality of care, which indicates that there may be room to improve medical services efficiency without significantly reducing the quality of care. The MLR does have a significantly positive effect on the aggregate quality ratings, however the magnitude of this effect is very small. This indicates that a minimum MLR requirement of 80% or 85% does not make a large difference on quality ratings.</subfield>
    </datafield>
    <datafield tag="650" ind1=" " ind2="4">
      <subfield code="0">MAPA20080579258</subfield>
      <subfield code="a">Cálculo actuarial</subfield>
    </datafield>
    <datafield tag="650" ind1=" " ind2="4">
      <subfield code="0">MAPA20080548100</subfield>
      <subfield code="a">Medicaid</subfield>
    </datafield>
    <datafield tag="650" ind1=" " ind2="4">
      <subfield code="0">MAPA20080593674</subfield>
      <subfield code="a">Sistemas sanitarios</subfield>
    </datafield>
    <datafield tag="773" ind1="0" ind2=" ">
      <subfield code="w">MAP20077000239</subfield>
      <subfield code="t">North American actuarial journal</subfield>
      <subfield code="d">Schaumburg : Society of Actuaries, 1997-</subfield>
      <subfield code="x">1092-0277</subfield>
      <subfield code="g">01/03/2021 Tomo 25 Número 1 - 2021 , p. 1-16</subfield>
    </datafield>
  </record>
</collection>