Political Strategies of Safety-Net Providers in Response to Medicaid Managed Care Reforms Export

@article{citeulike:4080612, abstract = {Safety-net providers play a central role in the U.S. health care system because they provide the bulk of services to the poor and the uninsured. The health policy literature focuses a great deal on the capacity of these institutions to provide services and the forces that shape these institutions and the services they provide, yet little is made of safety-net providers' potential role as advocates for the poor and for disadvantaged groups. In this article, we draw on findings from a case study of Medicaid policy making in Connecticut to explore efforts by safety-net providers and other nonprofit organizations to advocate around health care policy for the poor. Our findings illustrate how the capacity of nonprofit advocates to represent the poor can be compromised when the rules of the game change and nonprofit providers are asked to compete with for-profit organizations. We find that under a change in the contracting regime--from collaboration to competition--nonprofit service providers may increase political activity to secure a favorable role under the new regime, but these efforts may compromise their ability to act as representatives of the poor. 10.1215/03616878-2008-990}, author = {Grogan, Colleen M. and Gusmano, Michael K.}, citeulike-article-id = {4080612}, citeulike-linkout-0 = {http://dx.doi.org/10.1215/03616878-2008-990}, citeulike-linkout-1 = {http://jhppl.dukejournals.org/cgi/content/abstract/34/1/5?etoc}, day = {1}, doi = {10.1215/03616878-2008-990}, journal = {Journal of Health Politics Policy and Law}, keywords = {disperities, policy, public\_health, sociology}, month = {February}, number = {1}, pages = {5--35}, posted-at = {2009-02-23 00:38:17}, priority = {3}, title = {Political Strategies of Safety-Net Providers in Response to Medicaid Managed Care Reforms}, url = {http://dx.doi.org/10.1215/03616878-2008-990}, volume = {34}, year = {2009} }

TY - JOUR ID - citeulike:4080612 L3 - citeulike-article-id:4080612 N2 - Safety-net providers play a central role in the U.S. health care system because they provide the bulk of services to the poor and the uninsured. The health policy literature focuses a great deal on the capacity of these institutions to provide services and the forces that shape these institutions and the services they provide, yet little is made of safety-net providers' potential role as advocates for the poor and for disadvantaged groups. In this article, we draw on findings from a case study of Medicaid policy making in Connecticut to explore efforts by safety-net providers and other nonprofit organizations to advocate around health care policy for the poor. Our findings illustrate how the capacity of nonprofit advocates to represent the poor can be compromised when the rules of the game change and nonprofit providers are asked to compete with for-profit organizations. We find that under a change in the contracting regime--from collaboration to competition--nonprofit service providers may increase political activity to secure a favorable role under the new regime, but these efforts may compromise their ability to act as representatives of the poor. 10.1215/03616878-2008-990 IS - 1 JF - Journal of Health Politics Policy and Law EP - 35 TI - Political Strategies of Safety-Net Providers in Response to Medicaid Managed Care Reforms VL - 34 SP - 5 KW - disperities KW - policy KW - public_health KW - sociology AU - Grogan, Colleen AU - Gusmano, Michael PY - 2009/02/01/ UR - http://dx.doi.org/10.1215/03616878-2008-990 ER -