Medicaid's Next Metamorphosis

• 成果类型: Article
• 署名作者: Brecher, Charles; Rose, Shanna
• 署名单位: New York University
• 刊物名称: PUBLIC ADMINISTRATION REVIEW
• ISSN/ISSBN: 0033-3352
• DOI: 10.1111/puar.12116
• 发表日期: 2013
• 页码: S60-S68
• 关键词: health-care; POLITICS; POLICY; PROGRAMS; REFORM; expenditures; eligibility; POOR

摘要

Medicaid's transformation since its inception rivals the biological changes of metamorphosis, and this process is not yet over. Past metamorphoses include the change from a small program with eligibility linked to the states' cash welfare benefits to one with national eligibility standards covering many not receiving cash benefits; from a traditional fee-for-service payment program to one dominated by capitated managed care arrangements; and, under the Patient Protection and Affordable Care Act of 2010, to a widely accepted component of a national system for near-universal insurance coverage. An analysis of the forces behind these significant changes suggests that future transformations are likely. Four potential scenarios are presented and assessed.