Medical Care Research and Review

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

The Diabetes Educator

Click here to browse AJSM online!

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Zingmond, D. S.
Right arrow Articles by Cunningham, W. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zingmond, D. S.
Right arrow Articles by Cunningham, W. E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Medical Care Research and Review, Vol. 64, No. 1, 66-82 (2007)
DOI: 10.1177/1077558706296243
© 2007 SAGE Publications

The Impact of Managed Care on Access to Highly Active Antiretroviral Therapy and on Outcomes among Medicaid Beneficiaries with AIDS

David S. Zingmond

University of California—Los Angeles

Susan L. Ettner

University of California—Los Angeles

William E. Cunningham

University of California—Los Angeles

Medicaid has promoted managed care plans (MCPs) to control health care costs for HIV-infected enrollees. This article examines the impact of MCP enrollment on use of highly active antiretroviral therapy (HAART), antiretroviral therapy (ARV), hospitalization, and death among Medicaid beneficiaries with AIDS. A retrospective longitudinal cohort study of 7,028 Medicaid beneficiaries with AIDS in California was conducted from 1999 to 2001. The impact of MCP enrollment was estimated using single-equation and bivariate probit models. Baseline HAART use was found to be significantly lower for beneficiaries in MCPs versus fee-for-service (FFS). The effect was attenuated and not significant after correcting for selection bias. MCP enrollment was not associated with overall ARV use, mortality, or hospitalization. MCP enrollment does not substantially affect medication use or clinical outcomes. Before making changes to care delivery, policy makers should address the potential costs and benefits of MCP over FFS Medicaid for chronically ill beneficiaries.

Key Words: Medicaid • managed care • AIDS • HIV • HAART • antiretroviral therapy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?