Assessing the Impact of an Integrated Care System on the Healthcare Expenditures of Children With Special Healthcare Needs

作者：Marcu Mircea I; Knapp Caprice A; Brown David^*; Madden Vanessa L; Wang Hua

来源：American Journal of Managed Care, 2016, 22(4): 272-+.

Objectives: The Children's Medical Services Network, a carved-out fee-for-service healthcare system for Florida's children with special healthcare needs (CSHCN), chose to develop an integrated care system (ICS) for its enrollees. The goals of this study were to analyze the effects of a managed care program on the Medicaid expenditures of CSHCN and to evaluate the performance of econometric models used to analyze healthcare expenditures.
Study Design: We used administrative data from 3947 CSHCN enrolled in Florida's Medicaid program between 2006 and 2008 for 2 treatment and 2 control counties. The 2 treatment counties were subject to the new managed care ICS.
Methods: To account for the unique nature of healthcare expenditures data, 5 econometric models were constructed. Using a difference-in-differences approach, these models were used to estimate differences in healthcare expenditures between CSHCN in the reform and control counties.
Results: The ICS program decreased outpatient, inpatient, pharmacy, and total costs. These effects were statistically significant for 1 of the reform counties. Emergency department costs increased slightly, though not significantly. Among the econometric models, the generalized linear models outperformed the ordinary least squares regressions.
Conclusions: This analysis provides evidence that managed care programs such as Florida's ICS have the potential to reduce healthcare expenditures.

• 出版日期2016-4