Navigating managed care: Using CAHPS surveys to monitor patients with disabilities, newly-transitioned from Medicaid Fee-For-Service (FFS) into a large urban Medicaid health plan

Mid-year in 2011, California began transitioning Medicaid patients with disabilities from fee-for-service (FFS) into managed care coverage. Agencies, health plans, providers, families, and the advocacy community share an interest in monitoring how these patients have fared in accessing services and navigating managed care.

(1) Study design: This study is based on an oversample of former-FFS patients as part of the annual Health Plan CAHPS survey. It captures former-FFS patients transitioned from June 2011 forward, to provide interim findings about the impacts of the policy.

(2) Setting: Data are from a large urban Medicaid health plan in southern California, serving a diverse population.

(3) Descriptive findings: The presentation will report former-FFS patients' assessments about the quality of health care services in managed care. CAHPS asks patients to assess health plans, primary care doctors, specialists, health care, ease-of-access, speed of access, provider communication, customer service, and other factors.

(4) Analysis: The presentation will compare the quality of services reported by former-FFS patients with disabilities versus the general Medicaid population in the health plan. The former-FFS patients will be contrasted with a small sample of patients with disabilities already in managed care. These comparisons seek to identify services that require further adaptation to accommodate the incoming population.

(5) Other implications: The study will explore areas of strength and weakness in services assessed by patients with disabilities. The discussion will include lessons learned about the impact of the transition on patients, providers, clinics, health plan operations, and on the design of services.