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Effect of Different Types of Medicaid Managed Care on Childhood Immunization Rates

Kathy A. McDonald

Dawn A. Parker

Donna K. McClish

Carol B. Pugh

Virginia Commonwealth University

Viktor E. Bovbjerg

University of Virginia

Gary A. Tipton

Louis F. Rossiter

Wally R. Smith

Virginia Commonwealth University

Medicaid managed care can improve access to prevention services, such as immunization, for low-income children. The authors studied immunization rates for 7,356 children on Medicaid in three managed care programs: primary care case management (PCCM; n = 4,605), a voluntary HMO program (n = 851), and a mandatory HMO program (n = 1,900). Immunization rates (3:3:1 series) in PCCM (78%) exceeded rates in the voluntary HMO program (71%), which in turn exceeded those in the mandatory HMO program (67%). Adjusting for race, urban residence, and gender, compared to children in PCCM, children in the voluntary HMO program were less likely to complete the 3:3:1 series (OR = 0.75, CI = 0.63, 0.90), and children in the mandatory HMO program were even less likely to complete the series (OR = 0.59, CI = 0.51, 0.68). Results differed by individual HMOs. Monitoring of outcomes for all types of managed care by Medicaid agencies is imperative to assure better disease prevention for low-income children.

Evaluation & the Health Professions, Vol. 23, No. 4, 397-408 (2000)
DOI: 10.1177/01632780022034688


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