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  • Title: Characteristics of Children in Medicaid Managed Care and Medicaid Fee-for-service, 2003-2005.
    Author: Lloyd PC, Simon AE, Parker JD.
    Journal: Natl Health Stat Report; 2015 Jun 08; (80):1-15. PubMed ID: 26079623.
    Abstract:
    OBJECTIVES: Medicaid claims have been used to characterize utilization patterns of child Medicaid beneficiaries. However, because states are increasingly adopting Medicaid managed care plans, analyses of children enrolled in Medicaid based only on claims for fee-for-service (FFS) programs may not apply to the general Medicaid population. METHODS: The 2003-2005 National Health Interview Survey and 2003-2005 Medicaid Analytic eXtract linked files were used to examine associations between sociodemographic, health, and geographic characteristics of children aged 0-17 years and enrollment in Medicaid FFS compared with a comprehensive managed care (CMC) program. Additional analyses of age-specific health outcomes were performed on a subset of children aged 6-17 years. Chi-square tests were used to assess associations, and 95% confidence intervals are provided for point prevalence estimates. RESULTS: Higher percentages of children in CMC compared with FFS were non-Hispanic white, lived in families with income less than 100% of the federal poverty level, had excellent or very good health, lived in the Northeast and West, and lived in large central metro areas. No significant differences were observed by sex, age, and asthma diagnoses between children enrolled in CMC and FFS. Among children aged 6-17 years, higher percentages of children enrolled in FFS compared with children in CMC were diagnosed with learning disabilities or developmental delays and attention deficit hyperactivity disorder. Researchers using data from children enrolled only in Medicaid FFS programs to describe children enrolled in Medicaid should understand differences between children in CMC and FFS. Generalization of study results from FFS claims may depend on the outcomes examined.
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