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Medicaid: from Conceptualization to Action

Some of the basic elements affecting the formulation, implementation, and evaluation of health programs for the urban poor are developed. The Medicaid program is examined as an example of recent Federal efforts to upgrade the health status of indigent population of the United States. The rapidly rising costs of medical care and the unexpectedly high costs of Medicaid serve to reemphasize the need to carefully evaluate the merits and effectiveness of the Medicaid approach. Variations in state Medicaid plans, nonfiscal problems in coordination and administration, and the inadequacy of available data contribute to lack of effective and continuous program evaluation efforts. With this in mind, requirements for development of an effective management information system for Medicaid are spelled out. Specific examples of the kinds of information needed are given, and some steps taken recently by the federal government to attempt to meet identified needs are highlighted. The role of a management information system for Medicaid is seen in context as a component of a management approach to health programming.