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KMID : 1235020200140010013
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Health Service Management Review
2020 Volume.14 No. 1 p.13 ~ p.23
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Texas Medicaid Reform : Evaluations and Tasks
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Min In-Sik
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Abstract
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This study reviews Texas Medicaid Reform as known as Texas Waiver Demonstration Project beginning from 2012. The Waiver project has been a massive experiment in transforming Medicare program in Texas. Texas Medicaid Waiver anticipated savings from Medicaid managed care (MMC) expansion to improve health care quality and health outcomes, as well as to reduce medical expenditure. The Waiver project expanded MMC statewide, replacing PCCM in rural area, carving-in prescription drug benefits, non-behavioral inpatient hospitalization and transforming the Children’s Medicaid Dental Program. To evaluate the initial 5-year program of Waiver (2012 ~ 2016), four specific evaluation goals are analyzed regarding MMC expansion; Access to care, Coordination of care, Quality of care, Efficiently improved and cost decreased. As a statical analysis, pre-post study design is used to evaluate the MMC expansion and benefits into new SDAs. Interrupted Time Series(ITS) analysis uses aggregate data collected before and after a policy change. On average, by SDA(Service Delivery Area), MMC increased access to care and utilization for STAR and STAR+PLUS programs. Although dental utilization continues to exceed national objective for access, there were marked decreased by sex and age after MMC expansion. Although MMC expansion statewide has made progress, the benefits offered continue to change, suggesting that further evaluation will be implemented to identify long-term impact on overall Texas Medicaid Efficiency.
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KEYWORD
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ACA(Affordable Care Act), Waiver, Texas, Medicaid, MMC(Medicaid Managed Care)
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FullTexts / Linksout information
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Listed journal information
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