Evaluation of the MediPASS Managed Care Demonstration Project

Third Waiver Period Final Report
Fiscal Years 1995-1996

Elizabeth T. Momany
Peter C. Damiano
Jean C. Willard
Jay W. Meyer

February 1997

In 1990, the Iowa Department of Human Services introduced a Medicaid managed care demonstration project called the Medicaid Patient Access Service System (MediPASS) in seven counties (Black Hawk, Jackson, Linn, Muscatine, Polk, Pottawattamie and Scott). As a part of the federal waiver to begin the MediPASS program, an independent evaluation of the impact of the program on cost, access and quality was required by the Health Care Financing Administration.

This report presents the results of the evaluation of the third waiver period for the MediPASS program (fiscal years 1995 and 1996) and is the fourth report in a series evaluating the program. This evaluation introduces a new methodology for evaluating the program during the expansion of the MediPASS program beyond the original cost-effectiveness analysis for the program changed dramatically in an effort to account for the expansion of the program. Previous evaluations compared the costs in the seven MediPASS counties with the cost experience in seven comparison counties to estimate the effect of the program on costs. For this evaluation, a more sophisticated analytic technique was used to evaluate the impact of costs while the program was being phased in statewide. This report also includes recipient and physician perceptions of the Medicaid HMO which began a rapid expansion in the fall of 1993. As of July 1996, there were 82 counties participating in the MediPASS program and 42 counties with a Medicaid HMO option.

The effect of the MediPASS program on recipients' access to and quality of care were evaluated through surveys conducted with both physicians and recipients in the state. While not meant to be exhaustive, these different perspectives provide an overview of the impact of the MediPASS program on cost, quality and access.

Research for this evaluation was conducted by a team of researchers at the University of Iowa Public Policy Center. Funding was provided by the Iowa Department of Health and Human Services, Health Care Financing Administration.

77 pp., 1 figure, perfect binding