IDEAS home Printed from https://ideas.repec.org/a/taf/uaajxx/v25y2021i1p1-16.html
   My bibliography  Save this article

Medicaid Managed Care: Efficiency, Medical Loss Ratio, and Quality of Care

Author

Listed:
  • Patrick Brockett
  • Linda Golden
  • Charles C. Yang
  • David Young

Abstract

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.

Suggested Citation

  • Patrick Brockett & Linda Golden & Charles C. Yang & David Young, 2021. "Medicaid Managed Care: Efficiency, Medical Loss Ratio, and Quality of Care," North American Actuarial Journal, Taylor & Francis Journals, vol. 25(1), pages 1-16, January.
    • Handle: RePEc:taf:uaajxx:v:25:y:2021:i:1:p:1-16
    DOI: 10.1080/10920277.2019.1678044
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1080/10920277.2019.1678044
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1080/10920277.2019.1678044?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Patricia H. Born & Evan M. Eastman & E. Tice Sirmans, 2023. "Managed care or carefully managed? Management of underwriting profitability by health insurers," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 5-31, January.
    2. Perry, Teresa & Bernasek, Alexandra, 2024. "Profits over care? An analysis of the relationship between corporate capitalism in the healthcare industry and cancer mortality in the United States," Social Science & Medicine, Elsevier, vol. 349(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:taf:uaajxx:v:25:y:2021:i:1:p:1-16. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Longhurst (email available below). General contact details of provider: http://www.tandfonline.com/uaaj .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.