This study attempted to identify the association between the burden of Medicaid Managed Care and the hospital's response to that burden in terms of the impact on patient charges. The study involved the use of a nationwide patient data set that included the most complete cost, charge and clinical data available. Procedure specific burden measures were created to operationalize the burden of Medicaid Managed Care (MMC) as the percent of MMC for each procedure of study. The dependent variable was patient charges for each procedure and was analyzed using a multilevel model that accounted for the random effect of hospital in the regression. The key independent variable of interest (Burden of MMC) was found to be significantly associated with increases in patient charges. Several covariates were also found to be significantly associated with differences in patient charges. These included hospital profit motive (cost to charge ratio), patient severity of illness (APR_SEV), discharge year, payer, geographic region of the country, discharge status and the specialty of the admitting physician. The findings, among the high cost procedures of study, were that the effect of Medicaid Managed Care on patient charges were consistent in that the greater the burden of Medicaid Managed Care, the higher the patient charges.
","abstract_html":"<p>This study attempted to identify the association between the burden of Medicaid Managed Care and the hospital's response to that burden in terms of the impact on patient charges. The study involved the use of a nationwide patient data set that included the most complete cost, charge and clinical data available. Procedure specific burden measures were created to operationalize the burden of Medicaid Managed Care (MMC) as the percent of MMC for each procedure of study. The dependent variable was patient charges for each procedure and was analyzed using a multilevel model that accounted for the random effect of hospital in the regression. The key independent variable of interest (Burden of MMC) was found to be significantly associated with increases in patient charges. Several covariates were also found to be significantly associated with differences in patient charges. These included hospital profit motive (cost to charge ratio), patient severity of illness (APR_SEV), discharge year, payer, geographic region of the country, discharge status and the specialty of the admitting physician. The findings, among the high cost procedures of study, were that the effect of Medicaid Managed Care on patient charges were consistent in that the greater the burden of Medicaid Managed Care, the higher the patient charges.</p>","abstract_has_math":false,"creators":["Pate, Margarita Morales"],"institution":null,"degree_name":"Ph.D.","degree_level":"Campus Access Dissertation","degree_discipline":"Health Services and Policy Management","degree_department":null,"school":null,"contributors":["Sudha Xirasagar"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012-01-01T08:00:00Z","date_published":"2012-01-01T08:00:00Z","updated_at":"2026-07-24T04:38:37Z","subjects":["Health Services Administration","Medicine and Health Sciences","Public Health"],"languages":[],"rights":["© 2012, Margarita Morales Pate"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarcommons.sc.edu/etd/1396","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Sudha Xirasagar"]},{"key":"dc:creator","label":"Author","values":["Pate, Margarita Morales"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Health Services and Policy Management"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Campus Access Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph.D."]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Health Services Administration","Medicine and Health Sciences","Public Health"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["© 2012, Margarita Morales Pate"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarcommons.sc.edu/etd/1396"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["This study attempted to identify the association between the burden of Medicaid Managed Care and the hospital's response to that burden in terms of the impact on patient charges. The study involved the use of a nationwide patient data set that included the most complete cost, charge and clinical data available. Procedure specific burden measures were created to operationalize the burden of Medicaid Managed Care (MMC) as the percent of MMC for each procedure of study. The dependent variable was patient charges for each procedure and was analyzed using a multilevel model that accounted for the random effect of hospital in the regression. The key independent variable of interest (Burden of MMC) was found to be significantly associated with increases in patient charges. Several covariates were also found to be significantly associated with differences in patient charges. These included hospital profit motive (cost to charge ratio), patient severity of illness (APR_SEV), discharge year, payer, geographic region of the country, discharge status and the specialty of the admitting physician. The findings, among the high cost procedures of study, were that the effect of Medicaid Managed Care on patient charges were consistent in that the greater the burden of Medicaid Managed Care, the higher the patient charges.
"]},{"key":"dc:title","label":"Title","values":["Healthcare Cost Implications of Medicaid Managed Care"]}]}],"canonical_facts":{"dc:contributor":["Sudha Xirasagar"],"dc:creator":["Pate, Margarita Morales"],"dc:description.abstract":["This study attempted to identify the association between the burden of Medicaid Managed Care and the hospital's response to that burden in terms of the impact on patient charges. The study involved the use of a nationwide patient data set that included the most complete cost, charge and clinical data available. Procedure specific burden measures were created to operationalize the burden of Medicaid Managed Care (MMC) as the percent of MMC for each procedure of study. The dependent variable was patient charges for each procedure and was analyzed using a multilevel model that accounted for the random effect of hospital in the regression. The key independent variable of interest (Burden of MMC) was found to be significantly associated with increases in patient charges. Several covariates were also found to be significantly associated with differences in patient charges. These included hospital profit motive (cost to charge ratio), patient severity of illness (APR_SEV), discharge year, payer, geographic region of the country, discharge status and the specialty of the admitting physician. The findings, among the high cost procedures of study, were that the effect of Medicaid Managed Care on patient charges were consistent in that the greater the burden of Medicaid Managed Care, the higher the patient charges.
"],"dc:identifier":["https://scholarcommons.sc.edu/etd/1396"],"dc:rights":["© 2012, Margarita Morales Pate"],"dc:subject":["Health Services Administration","Medicine and Health Sciences","Public Health"],"dc:title":["Healthcare Cost Implications of Medicaid Managed Care"],"thesis:degree_discipline":["Health Services and Policy Management"],"thesis:degree_level":["Campus Access Dissertation"],"thesis:degree_name":["Ph.D."]},"updated_at":"2026-07-24T04:38:37Z"}