Fee-for-Service Medicaid And Medicaid Managed Care: Differentiating Chronic Disease Outcomes

Fee-for-Service Medicaid And Medicaid Managed Care: Differentiating Chronic Disease Outcomes

Author: 
Lou Edwards
Program of study: 
D.H.A.
Abstract: 
In this study, there was an exploration of the influence that managed care had on the chronically ill population by comparing the outcomes of those Medicaid recipients served under managed care versus the traditional fee-for-service model. Inpatient hospital stays, outpatient hospital visits, and emergency department visits were used to measure health outcomes; the rendering of fewer of these types of services is a positive indicator since this most likely equates with the attainment of better health status. The frequency of doctors’ visits and diagnostic tests as well as the number of prescriptions issued were used as measures of access, and a negative indicator only existed if a limited number of these types of services are used since this means people are receiving poorer service and minimal benefits. The data was collected from the Household and Medical Components of MEPS. The study results were for both diabetes and hypertension the hypothesis was confirmed as it relates inpatient hospital stays and outpatient visits, and doctor visits in the predicted direction but was disconfirmed in regard for emergency visits, diagnostic tests, and prescription because it was in the opposite direction from predicted. For asthma, the null hypothesis must be accepted as it relates to inpatient visits, emergency department visits, inpatient visits, doctor visits, and prescription medications. However, there is a difference for diagnostic testing, but it is not in the predicted directions.
Dedication: 
First, I would like to dedicate this project to my Lord and Savior who is the center of all I do. Diane Bergman, there are not words that can express gratitude and thankfulness for your insight, wisdom, encouragement, intelligence, and laughter. There were times when I wanted to give up but your encouragement help me to stay the course. I would like to show appreciation to you for being who you are a great friend. I would like to acknowledge Jessica and AJ for your considerate, and sacrifice through this process. I would like to mention my father Dave Walker and to my Grandfathers Dave Walker, Daniel Showers who give me the gift of wanting to learn and opened my eyes to the fact that learning is an entry to the world. They taught me that learning was a powerful that fix many thing. To my sibling Dave, Daphne, Arthur, Katrina and LaSalle who always have supported me. To my mother Eliza Scott who give me life. To my church family especially Mother and Michelle and to my friend who love me always.
Acknowledgements: 
I must first acknowledge God my father who is the center of my life. God give me the vision to start this program and the faith and grace to complete it. Many people supported and encouraged me during this demanding and inspiring process. A special thanks to my family, friends, and church home that prayed and supported me during this process. I am so appreciative to my Committee Chairperson, Dr. Gaynel Olsen, was an inspiration who give direction during this journey. To my committee members Dr. Lois Ramer and Dr. Maria Navarro, I appreciate their knowledge, insight, expertise, help, support and continued encouragement.