Medicaid in Transition

A growing number of states, governed by chief executives with a variety of political perspectives, are moving forward to redesign their Medicaid programs, generally through changes that emphasize management of the care delivered and less freedom for beneficiaries to select their own providers of care. Recently in Boston, in a development that runs counter to this national trend, a Medicaid reform proposal presented by a consortium of Boston hospitals and neighborhood health centers collapsed, the victim of a liberal Democratic governor's administration, which viewed the concept as contrary to the best interests of the poor.The process of negotiations between . . .