Opportunities and challenges in Medicaid managed care: the experience in Maryland.

OBJECTIVE: The effects of the Maryland Medicaid mandatory managed care programs on Medicaid beneficiaries are examined with the main objective of gaining insight into the initial experience and beneficiary satisfaction with Maryland's Medicaid program. The background of the Maryland Medicaid system, initial implementation, results of beneficiary satisfaction surveys, and future concerns are discussed. STUDY DESIGN: An observational study based on survey data. DATA AND METHODS: Beneficiary surveys mailed to adult and child participants in HealthChoice and the Rare and Expensive Case Management (REM) Medicaid programs in Maryland are analyzed. Descriptive univariate and bivariate data statistics are used. RESULTS: The 4 questions rating satisfaction with primary care provider (PCP), relevant specialists, all providers, and the overall health plan indicate high levels of satisfaction in both adult and child populations. CONCLUSIONS: The Maryland Medicaid programs appear to have met the goal of providing a comprehensive, coordinated healthcare system of quality care during their first year of operation. The satisfaction of these beneficiaries suggests that with an appropriate risk-adjusted capitation approach, managed care organizations (MCOs) can successfully provide for even the most complex needs of Medicaid members.