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As states pursue Medicaid managed care, price and market competition threatens health care providers who have depended on Medicaid funds and cost-shifting to support indigent health care, medical education, and other important health care functions. This report discusses some of the economic and quality-control issues faced by state policymakers as they work to ensure access to appropriate health care for traditionally vulnerable populations, maintain other important state-supported health care functions, and provide a cost-effective delivery system through Medicaid managed care.
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