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Letters |

Medication Dispensing and Medicaid Managed Care—Reply

Arnold M. Epstein, MD, MA
JAMA. 1998;279(12):912-913. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-12-jbk0325.
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In Reply.—Drs Schillinger and Ofman describe an unfortunate situation. Health plans that adopt restrictions on the supply of medications to Medicaid enrollees likely believe that these restrictions will result in lower pharmaceutical expenditures and lower costs overall. Schillinger and Ofman argue that the health plans are mistaken. Unfortunately, no matter who is right, Medicaid enrollees themselves will likely pay a price, either in terms of extra time and effort to obtain medications for chronic conditions on a monthly basis, or in terms of poor health outcomes when they fail to receive needed medications in a timely manner. The move to managed care offers the potential to improve health care for Medicaid enrollees by increasing integration and accountability, but improvement in care cannot be taken for granted.


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