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Medicaid's Next Metamorphosis
Author(s) -
Brecher Charles,
Rose Shanna
Publication year - 2013
Publication title -
public administration review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.721
H-Index - 139
eISSN - 1540-6210
pISSN - 0033-3352
DOI - 10.1111/puar.12116
Subject(s) - medicaid , cash , payment , business , metamorphosis , patient protection and affordable care act , welfare , actuarial science , health insurance , public economics , service (business) , health care , finance , economics , economic growth , marketing , biology , market economy , botany , larva
Medicaid's transformation since its inception rivals the biological changes of metamorphosis, and this process is not yet over. Past metamorphoses include the change from a small program with eligibility linked to the states’ cash welfare benefits to one with national eligibility standards covering many not receiving cash benefits; from a traditional fee‐for‐service payment program to one dominated by capitated managed care arrangements; and, under the Patient Protection and Affordable Care Act of 2010, to a widely accepted component of a national system for near‐universal insurance coverage. An analysis of the forces behind these significant changes suggests that future transformations are likely. Four potential scenarios are presented and assessed .