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Providers noted that patients had a difficult time understanding PCCM and that Medicaid families frequently used emergency rooms.
Re-running the MVRM and PCCM tests with these firms omitted did not change the signs and significance of the parameter estimates reported below and thus did not alter the authors' conclusions.
High-cost Medicaid recipients are often included in Medicaid managed care programs, including PCCM programs.
When these other factors are taken into account, in Georgia where SCHIP and Medicaid-covered children used the same provider network and PCCM structure, the probability of primary care use was 3 percent greater per quarter for SCHIP covered children with a history of Medicaid coverage, compared to income eligible Medicaid covered children (Table 3).
Using this method, the final prereform sample from Broward and Duval Counties included 5,152,099 member-months, with 656,855 eligible through SSI (36 percent enrolled in HMO, 60 percent enrolled in PCCM, and 4 percent in FFS) and 4,495,244 eligible through TANF (50 percent enrolled in HMO, 48 percent enrolled in PCCM, and 2 percent in FFS).
In theory, PCCM arrangements should offer all of the advantages that individuals receive from having an identifiable usual source of care, including better access to services, less use of emergency departments, and more regular use of preventive care (Rowland et al.
For example, states with PCCM models may need to give primary care providers greater incentives to increase preventive care receipt and to make appropriate referrals when follow-up care is needed.
We have worked with hospitals worldwide on various departmental operational transformation projects, but addressing enterprise-wide optimization is what the PCCM solution aims to tackle.
2 * -- in past 12 months (among smokers) All analyses are adjusted for age, sex, race/ethnicity, educational attainment, personal income, marital status, family size, health status, MSA, mandatory PHP in county, mandatory PCCM in county, county HMO penetration rate (1998), percentage of households that receive SSI in county (1999), percentage of county residents 25 years and older with HS/GED education (2000), 2-year lagged median household income, per capita income, population, % living in poverty, number of physicians/10,000 residents, state and year.
North Carolina's PCCM is unique among state programs in keeping all services, such as disease management and enrollment, within its own networks, rather than contracting with outside vendors.
Services are reimbursed on an FFS basis in the PCCM.
Counties with primary care case management program (PCCM) are included in the study because all medical services are reimbursed on fee-for-service basis in addition to a $3 per person per month PCCM fee.
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