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Disparities Found Between Medicaid, Commercial Patients

Care for Medicaid enrollees lags in different types of managed care programs

WEDNESDAY, Oct. 10 (HealthDay News) -- Enrollees in Medicaid managed-care programs receive a poorer quality of health care than those in commercial managed-care programs, based on a variety of quality indicators, researchers report in the Oct. 10 issue of the Journal of the American Medical Association.

Bruce E. Landon, M.D., of Harvard Medical School in Boston, and colleagues compared data from 383 health plans, divided between commercial-only, Medicaid/commercial and Medicaid-only plans. The investigators considered 11 quality-of-care indicators, such as immunizations and screenings, chronic disease management measures and care for pregnant women.

Performance on these measures for Medicaid enrollees was similar whether they were in a Medicaid-only plan or a commercial plan also serving the Medicaid populations. Performance was also similar for commercial enrollees, regardless of whether the program served commercial populations only or a mix of commercial and Medicaid enrollees. However, the performance for the commercial population was better than for the Medicaid population on all but one measure (chlamydia screening). These differences between the two groups were even found within the same health plans.

"Neither mainstreaming of Medicaid beneficiaries in commercial plans nor relying on Medicaid-only plans seems to raise the quality of care to the level experienced by commercial populations. Additional resources will need to be devoted to designing and implementing specific interventions to improve the quality of care for Medicaid beneficiaries enrolled in managed care," the authors write.

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