Press Release
Medicaid Managed Care: The Challenge of Providing Care to Low-Income Women

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February 19, 1998 Washington, DC -- Medicaid pays for nearly 40% of births in the United States and covers over 12% of all American women, making this joint federal-state health program critical to women's health. Today's presentation by Dr. Amy Bernstein of the Alpha Center, a nonprofit health policy research organization in Washington, DC, at the Jacobs Institute's sixth symposium on women's health and managed care addressed the various factors that affect how different types of Medicaid managed care plans will impact on women's health care. Most special managed care programs target issues related to prenatal and perinatal care and children's health, but "we dont know how plans differ in the care they provide to women who are not pregnant," said Bernstein. Of particular concern are women with special needs or serious health problems. While Medicaid managed care may help to alleviate some of the access problems that have traditionally plagued the program, most plans have little experience serving populations with special needs. States' demands for data on the quality of care delivered by their Medicaid managed care organizations vary widely, and few states require that their contracting plans receive independent accreditation. Low payment rates to health plans by states may also discourage plans from remaining in the Medicaid market, threatening enrollees' continuity of care.

New data from a 1995-96 Kaiser Family Foundation/Commonwealth Fund survey of low-income women were also reported at the symposium by Dr. Alina Salganicoff, of the Kaiser Commission on Medicaid and the Uninsured. Medicaid provides coverage to a more vulnerable group of low-income women than the private sector. Women in Medicaid managed care are experiencing poorer access, lower satisfaction, and greater problems; experience with Medicaid managed care thus far does not indicate that it has improved access and satisfaction with care. Recent policy changes granting states greater flexibility and leading to increased Medicaid managed care enrollment highlight the need for caution.

Other panelists at today's symposium included: Sara Rosenbaum, JD, Director of the Center for Health Policy Research at The George Washington University Medical Center; Mary Dewane, Chief Executive Officer for CalOPTIMA; Sylvia Drew Ivie, JD, Executive Director of T.H.E. Clinic in Los Angeles; and Fay Molly Biernat, MD, Medical Consultant for the New Jersey Division of Medical Assistance and Health Services.

"Medicaid Managed Care: The Challenge of Providing Care to Low-Income Women" is part of a two year project by the Jacobs Institute of Women's Health to explore the impact of managed care on health care services for women. An external advisory panel chaired by Carol S. Weisman, PhD, of the University of Michigan, includes representatives of the managed care industry, purchasers, physicians, and health services researchers. The project is addressing a range of topics, from primary care to quality issues, through a briefing paper series entitled Insights and symposia convened in Washington, DC. The symposia feature commissioned papers presenting original research and analysis by experts on specific aspects of managed care's effect on women's health, which are then published in Women's Health Issues, the official publication of the Jacobs Institute.

Support for the project has been provided by The Commonwealth Fund, The Henry J. Kaiser Family Foundation, Eli Lilly and Company, and Wyeth-Ayerst Laboratories. Additional information on the project, copies of the briefing paper Insights, and drafts of the commissioned paper by Dr. Bernstein are available from the Jacobs Institute at 202/863-4990.

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For Immediate Release

For more information contact:
Shannon R. Mouton
The Jacobs Institute
(202) 863-4989