Because the first MCO kept its claim data on the basis of the type of provider rendering the service, not the service rendered, DMA can not compare that data to that of the current contractor, which keeps its claims data on the basis of the service rendered. This problem will only be exacerbated by an increase in the number of clients served by HMOs, each of which has its own information system. Conclusion Anecdotal evidence and analysis of the limited data available raise cause for concern. Parents complain that they can not access acute services for their children. Recipients complain that they are being pushed on medications with side effects at the same time their therapy is being cut.
Administrative costs continue to rise.
The failure of government to attempt to monitor managed care is disgraceful. The ability of government to control multiple private companies with the financial incentive to cut services is questionable. The lack of political will to stop this runaway train would be inexcusable. The National Council on Disability should support legislation to prohibit all forms of capitation and risk-sharing that induce managed care companies and providers to cut services. The National Council also should pursue legislative and regulatory paths to prohibit any new Medicare and Medicaid forays with privately managed care.