Nicole Lurie, MD, MSPH; Jon Christianson, PhD; Ira Moscovice, PhD
Lurie N, Christianson J, Moscovice I. Capitation and the Medicaid Elderly. Ann Intern Med. 1994;121:469-470. doi: 10.7326/0003-4819-121-6-199409150-00033
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Published: Ann Intern Med. 1994;121(6):469-470.
At this time, the only way capitation can legally be implemented in a dually enrolled Medicare and Medicaid population is to capitate the Medicaid portion. Although this technically represents the copayment, it actually represented about half of patient expenditures for care in Minnesota. This is because Medicaid covers many services that Medicare does not. We believe it is important that in this particular real-world setting, enrolling dually enrolled Medicare/Medicaid beneficiaries in managed care plans was not measurably harmful to their health.
Careful monitoring will be necessary to see if our findings are generalizable to settings in which the entire payment is capitated or to settings that serve only capitated Medicaid populations.
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