Working Paper: NBER ID: w23518
Authors: Timothy Layton; Alice K. Ndikumana; Mark Shepard
Abstract: Medicaid, the government program for providing health insurance to low-income and disabled Americans, is the largest health insurer in the United States with more than 73 million enrollees. It is also the sector of the U.S. public health insurance system that relies most heavily on the tools of regulated competition with more than 60% of its enrollees enrolled in a private health plan in 2014. However, regulated competition in Medicaid differs from the typical model, emphasizing the tools of competitive procurement -- such as competitive bidding, the threat of exclusion from the market, and auto-assignment of enrollees to plans -- to attempt to improve efficiency, instead of relying primarily on the forces of consumer demand. In this paper, we discuss how Medicaid combines the tools of competitive procurement with the tools of regulated competition and some potential consequences of this hybrid model.
Keywords: No keywords provided
JEL Codes: I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| competitive procurement in Medicaid managed care (H57) | efficiency (D61) |
| regulatory mechanisms (L51) | plan performance (Y10) |
| Medicaid managed care design (I18) | quality of services (L84) |
| auto-assignment of enrollees to plans (I18) | competitive dynamics (L13) |