Pediatric outpatient utilization by differing Medicaid payment models in the United States.

ABSTRACT:

Background

In the United States (US), Medicaid capitated managed care costs are controlled by optimizing patients' healthcare utilization. Adults in capitated plans utilize primary care providers (PCP) more than emergency departments (ED), compared to fee-for-service (FFS). Pediatric data are lacking. We aim to determine the association between US capitated and FFS Medicaid payment models and children's outpatient utilization.

Methods

This retrospective cohort compared outpatient utilization between two payment models of US Medicaid enrollees aged 1-18 years using Truven's 2014 Marketscan Medicaid database. Children enrolled > 11 months were included, and were excluded for eligibility due to disability/complex chronic condition, lack of outpatient utilization, or provider ca

SUBMITTER: Canares TL 

PROVIDER: S-EPMC7291721 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature