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American Journal of Public Health, Vol. 88, Issue 3 464-466, Copyright © 1998 by American Public Health Association

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Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid.

O Carrasquillo, D U Himmelstein, S Woolhandler and D H Bor

Department of Medicine, Cambridge Hospital/Harvard Medical School, Mass., USA. carraso@medicine1.cpmc.columbia.edu

OBJECTIVES: The purpose of this study was to analyze duration of coverage among new Medicaid enrollees. METHODS: The 1991 Survey of Income and Program Participation was used to examined the duration of coverage for individuals who did not have Medicaid in January 1991 and obtained coverage by May 1993. RESULTS: Of new Medicaid enrollees, 38% (90% confidence interval [CI] = 34%, 42%) remained covered 1 year later; 26% (90% CI = 21%, 31%) remained covered at 28 months. Of those older than 65 years, 54% (90% CI = 31%, 77%) retained Medicaid for 28 months, vs 20% (90% CI = 14%, 26%) of children. Of people who lost Medicaid, 54% (90% CI = 31%, 77%) had no insurance the following month. CONCLUSIONS: Almost two thirds of new Medicaid recipients lose coverage within 12 months. It is unlikely that Medicaid managed care will enhance continuity of care for new recipients.


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