Medicaid Managed Care for Children with Special Health Care Needs: Examining Legislative and Judicial Constraints on Privatization

• Published in: Public administration review Vol. 64; no. 2; pp. 234 - 242
• Main Authors: Reed, Christine M., Meyer, Kyle P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2004; American Society for Public Administration
• Subjects: Access to Health Care; Administrative law; Beneficiaries; Bureaucracy; Child Health; Child health services; Child neglect; Child welfare; Children; Children & youth; Childrens health; Chronic illnesses; Delivery Systems; Disabilities; Government agencies; Health care; Health care policy; Health Insurance; Health policy; Health services; Influence; Legislation; Managed care; Managed Care Services; Management; Maternal & child health; Medicaid; Medical practices; Performance management; Privatization; Public Administration; Public health; Reform; Regulatory reform; Social responsibility; U.S.A; Waivers; United States > US
• ISSN: 0033-3352; 1540-6210
• DOI: 10.1111/j.1540-6210.2004.00364.x

Over the past decade, much has been written about the results of reinventing government. Most research has examined the effects of executive or managerial perspectives. Using David Rosenbloom's competing perspectives model, we examine Medicaid managed care programs for children with special health care needs to illustrate the influence of legislative and judicial institutional perspectives on the reinvention movement. Legislative and judicial responses to the reinvention of Medicaid managed care reveal the outer limits of what managed care and related executive reforms can accomplish in a Constitutional system that is based on checks and balances among competing institutional perspectives. Furthermore, relative to Medicaid managed care, legislative and judicial responses conserve public responsibility to society's most vulnerable populations. In the long run, the balance of institutional perspectives and values-not managerial innovation per se-will influence public administration.