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Quality Measurement in Medicaid Managed Care and Fee-for-Service

The New York State Experience

Bureau of Quality Management and Outcomes Measurement, Office of Managed Care/New York State Department of Health, Albany, New York, pjr02{at}health.state.ny.us

Jacqueline M. Butch, MBA

Quality Measurement Unit, Office of Managed Care/New York State Department of Health, Albany, New York

Joseph P. Anarella, MPH

Office of Managed Care/New York State Department of Health, Albany, New York

Foster Gesten, MD

Office of Managed Care/New York State Department of Health, Albany, New York

Kathleen Shure, MPA

Office of Managed Care/New York State Department of Health, Albany, New York

New York State has transitioned 1.7 million Medicaid recipients from a fee-for-service delivery system to a managed care model. To evaluate whether managed care has had a positive effect on access and quality, the New York State Department of Health compared rates of performance across standardized measures of quality (ie, childhood immunization, well-child visits, prenatal care in the first trimester, cervical cancer screening, use of appropriate medications for people with asthma, and comprehensive diabetes care) in both systems. For almost all measures, Medicaid managed care rates were statistically higher than Medicaid fee-for-service.

Key Words: Medicaid managed care • quality • performance measurement • Medicaid

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