Additionally, concurrent indicators for the presence of a Medicaid prepaid health plan (PHP) or primary care case management program (PCCM) in the county are included.
(3.) Primary care case management (PCCM) is a fee-for-service plan that provides comprehensive health care and case management of primary health care services.
Of the 3.6 million Medicaid enrollees in coordinated care in 1992, more than 1.1 million were in PCCMs, more than 728,000 were in Federally qualified HMOs, 752,000 were in PHPs, and nearly 850,000 were in State-defined HMOs.
Colorado also implemented the Primary Care Physician Program statewide in 1983 as one of the first PCCMs operating under a section 1915(b) freedom-of-choice waiver.
Florida also has a PCCM known as the "Florida Physician Access System" (MediPass), authorized under a 1915(b) waiver, which began providing services in four counties in the Tampa and St.
In PCCM programs, the state Medicaid agency contracts with a primary care gatekeeper entity (e.g., physician, clinic) that coordinates primary and specialty care for Medicaid beneficiaries.
States and counties can use PCCM or HMO only, or they can use both.
They found that gatekeeper PCCM programs increased the number of physician visits, and decreased inpatient stays, prescription drug use, and emergency room visits.
Despite favorable findings, the portability of the California COHS/HIO and PCCM models of delivering healthcare to other areas where racial composition is different needs to be explored as our study sample had fewer than 5 percent African Americans.
Thus, since the nature of the financial arrangement with the PCCM was not "full risk" (i.e., physicians were not penalized for hospitalization of a patient), physicians in both payor groups, given Medicaid populations similar with respect to their health status, performed the procedure (cesarean section) at a comparable rate.
Data limitations also precluded an analysis of differences in HAART receipt between PCCM
enrollees and traditional HMO enrollees.
MCO, managed care organization; PCCM
, primary care case management.