Effect of Mandated Managed Care for Medicaid Populations on the Practice ofPublic Health: The Example of Childhood Lead Poisoning Prevention

摘要

This report examines how the move towards managed care by state Medicaid programsaffects the provision of the major service components of the Centers for Disease Control and Prevention's (CDC) childhood lead Poisoning Prevention (CLPP) programs. It also examines how CLPP programs have responded to the challenges of managed care. Site visits to Rhode Island, Tennessee, Indiana, Pinellas County, Florida, and Minneapolis, Minnesota were conducted. The report finds that: (1) managed care will affect all components of CLPP programs to the degree that it leads to decentralization and privatization of functions that are currently centralized; (2) state and local health departments (S/LHDs) will spend less time on assurance and more on assessment and policy development under managed care; they will also have a diminished role in direct service delivery; and (3) many of the changes in the managed care environment may make it difficult to obtain the sort of data needed to perform new roles such as assessment and quality assurance functions adequately.