{"id":"https://openalex.org/W141734182","doi":null,"title":"Challenging the cost effectiveness of medi-cal managed care.","display_name":"Challenging the cost effectiveness of medi-cal managed care.","publication_year":2009,"publication_date":"2009-05-01","ids":{"openalex":"https://openalex.org/W141734182","mag":"141734182","pmid":"https://pubmed.ncbi.nlm.nih.gov/19561834","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/2691508"},"language":"en","primary_location":{"id":"pmh:oai:pubmedcentral.nih.gov:2691508","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/2691508","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"West J Emerg Med","raw_type":"Text"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/2691508","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110187746","display_name":"R. Myles Riner","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210158797","display_name":"CEP America","ror":"https://ror.org/04sygbn06","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210158797"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"R Myles Riner","raw_affiliation_strings":["Director of Provider Relations, CEP America"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Director of Provider Relations, CEP America","institution_ids":["https://openalex.org/I4210158797"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5110187746"],"corresponding_institution_ids":["https://openalex.org/I4210158797"],"apc_list":null,"apc_paid":null,"fwci":0.6863,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":{"value":0.81685521,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":93},"biblio":{"volume":"10","issue":"2","first_page":"124","last_page":"e8"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.0,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medicaid-managed-care","display_name":"Medicaid managed care","score":0.949999988079071},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.7609999775886536},{"id":"https://openalex.org/keywords/medi-cal","display_name":"Medi-Cal","score":0.7620000243186951},{"id":"https://openalex.org/keywords/cost-shifting","display_name":"cost shifting","score":0.6110000014305115},{"id":"https://openalex.org/keywords/risk-adjustment","display_name":"risk adjustment","score":0.7960000038146973},{"id":"https://openalex.org/keywords/provider-reimbursement","display_name":"provider reimbursement","score":0.6460000276565552},{"id":"https://openalex.org/keywords/health-care-incentives","display_name":"health care incentives","score":0.49399998784065247},{"id":"https://openalex.org/keywords/california","display_name":"California","score":0.9229999780654907}],"concepts":[{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.8936887979507446},{"id":"https://openalex.org/C2780265253","wikidata":"https://www.wikidata.org/wiki/Q1416012","display_name":"Managed care","level":3,"score":0.8717949986457825},{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.7319918870925903},{"id":"https://openalex.org/C29122968","wikidata":"https://www.wikidata.org/wiki/Q1414816","display_name":"Incentive","level":2,"score":0.6658624410629272},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6125267744064331},{"id":"https://openalex.org/C2777369334","wikidata":"https://www.wikidata.org/wiki/Q6806246","display_name":"Medicaid managed care","level":4,"score":0.509233832359314},{"id":"https://openalex.org/C2780253743","wikidata":"https://www.wikidata.org/wiki/Q132382","display_name":"Presumption","level":2,"score":0.4664539694786072},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.41436415910720825},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.3941251337528229},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3530244827270508},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.26340451836586},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C175444787","wikidata":"https://www.wikidata.org/wiki/Q39072","display_name":"Microeconomics","level":1,"score":0.0},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0}],"mesh":[],"locations_count":6,"locations":[{"id":"pmh:oai:pubmedcentral.nih.gov:2691508","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/2691508","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"West J Emerg Med","raw_type":"Text"},{"id":"pmid:19561834","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/19561834","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The western journal of emergency medicine","raw_type":"Journal Article"},{"id":"pmh:qt0t9113s3","doi":null,"is_oa":true,"landing_page_url":"http://www.escholarship.org/uc/item/0t9113s3","pdf_url":"http://www.escholarship.org/uc/item/0t9113s3","source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Riner, R. Myles. (2009). Challenging the Cost Effectiveness of Medi-Cal Managed Care. Western Journal of Emergency Medicine, 10(2). Retrieved from: http://www.escholarship.org/uc/item/0t9113s3","raw_type":"article"},{"id":"pmh:oai:doaj.org/article:b67654f2c66f4753b523ef27a206cc63","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/b67654f2c66f4753b523ef27a206cc63","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Western Journal of Emergency Medicine, Vol 10, Iss 2, Pp 124-129 (2009)","raw_type":"article"},{"id":"pmh:oai:escholarship.org/ark:/13030/qt0t9113s3","doi":null,"is_oa":false,"landing_page_url":"https://escholarship.org/uc/item/0t9113s3","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, vol 10, iss 2","raw_type":"article"},{"id":"mag:2766728382","doi":null,"is_oa":true,"landing_page_url":"https://escholarship.org/content/qt0t9113s3/qt0t9113s3.pdf","pdf_url":null,"source":{"id":"https://openalex.org/S2738799989","display_name":"Western Journal of Emergency Medicine","issn_l":"1936-900X","issn":["1936-900X","1936-9018"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","medline","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320339","host_organization_name":"eScholarship Publishing, University of California","host_organization_lineage":["https://openalex.org/P4310320339"],"host_organization_lineage_names":["eScholarship Publishing, University of California"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":null,"is_accepted":false,"is_published":false,"raw_source_name":"Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health","raw_type":null}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:2691508","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/2691508","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"West J Emerg Med","raw_type":"Text"},"sustainable_development_goals":[{"score":0.5683000087738037,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W141734182.pdf","grobid_xml":"https://content.openalex.org/works/W141734182.grobid-xml"},"referenced_works_count":9,"referenced_works":["https://openalex.org/W31191929","https://openalex.org/W2018353007","https://openalex.org/W2042433511","https://openalex.org/W2100943105","https://openalex.org/W2117531669","https://openalex.org/W2158315492","https://openalex.org/W2159956853","https://openalex.org/W2170568733","https://openalex.org/W2994231305"],"related_works":["https://openalex.org/W2766728382","https://openalex.org/W2411377777","https://openalex.org/W2992527663","https://openalex.org/W1966789526","https://openalex.org/W2427363125","https://openalex.org/W2384268352","https://openalex.org/W2205916714","https://openalex.org/W2989349388","https://openalex.org/W2029285055","https://openalex.org/W2102185182"],"abstract_inverted_index":{"Some":[0],"researchers":[1],"and":[2,30,35,70,73,96,118,121],"consulting":[3],"groups":[4],"have":[5,38],"promoted":[6],"managed":[7,57,102],"care":[8,16,58,103],"as":[9,49],"a":[10,50,62],"way":[11],"to":[12,17,60,75,116,138,152,164],"provide":[13,139],"cost-effective":[14],"quality":[15],"Medicaid":[18,46,67,147],"patients,":[19],"based":[20],"on":[21,131],"assertions":[22],"that":[23,84,93],"are":[24,136],"often":[25],"poorly":[26],"substantiated.":[27],"Unfortunately,":[28],"politicians":[29],"policy":[31],"makers":[32],"in":[33,99,107,160,162],"California":[34,108],"other":[36,110],"states":[37],"adopted":[39],"the":[40,43,54,76,82,94],"presumption":[41],"of":[42,45,56,65,123,146],"cost-effectiveness":[44],"Managed":[47,86,148],"Care":[48,87,149],"rationale":[51],"for":[52,142,157],"expanding":[53],"use":[55],"programs":[59,150],"include":[61],"larger":[63],"share":[64],"more":[66,140],"eligible":[68],"enrollees,":[69],"expand":[71],"coverage":[72],"services":[74,141],"currently":[77],"uninsured.":[78],"This":[79,126],"paper":[80],"challenges":[81],"assertion":[83],"Medi-Cal":[85,101,133],"is":[88],"cost":[89],"effective,":[90],"by":[91],"demonstrating":[92],"unique":[95],"idiosyncratic":[97],"manner":[98],"which":[100],"has":[104],"been":[105],"implemented":[106],"(and":[109],"states)":[111],"creates":[112],"perverse":[113],"incentives":[114,166],"leading":[115],"cost-shifting":[117],"selective":[119],"enrollment":[120],"dis-enrollment":[122],"costly":[124],"beneficiaries.":[125],"places":[127],"an":[128],"unfair":[129],"burden":[130],"fee-for-service":[132],"providers,":[134],"who":[135],"expected":[137],"less":[143],"reimbursement.":[144],"Administrators":[145],"need":[151],"consider":[153],"risk":[154],"adjusted":[155],"rates":[156],"beneficiaries":[158],"enrolled":[159],"plans":[161],"order":[163],"align":[165],"with":[167],"program":[168],"objectives.":[169],"[WestJEM.":[170],"2009;10:124-129.]":[171]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2014,"cited_by_count":1},{"year":2012,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}
