We examined managed care (MC) knowledge and practices among urban parents, using a 76-item cross-sectional survey in several Boston communities. Most of the 1100 participants were poor, minority, and single parents. 68% of children had public insurance, 17%, private, and 16%, none; half of insured children had MC coverage. 62% of parents didn’t know what MC was, 13% correctly said it was insurance, and only 2% correctly identified defining features. Proportions of incorrect parental responses on MC included: 63-80%, copay may be needed for prescriptions or visits to ER or child’s MD; 79-89%, MDs may get incentive for fewer tests/procedures, maximizing number of patients/day, or not making subspecialist referrals; 80%, MD may be subject to gag rule; and 63%, prior approval always needed for ER visit. Parents of MC insured children significantly more often gave correctly responses for these issues, but 52-84% responded incorrectly. Proportions of parents who would take children to the ER without prior approval included: for ankle sprain, 92%; earache, 86%; diarrhea, 72%; and rash, 59%. In multivariate analyses of 15 outcomes, only Latino ethnicity was associated with not knowing what MC is (OR, 3.0; 95% CI, 2.0-5.0) and with incorrect responses about MC issues. Regardless of their child’s insurance, most urban parents don’t know what MC is; are unaware of copays, MD incentives and gag rules; and believe that prior approval for ER visits is unnecessary. MC misinformation can cause needless financial burden and inefficient resource use. Urban parents need better, more comprehensible information about MC.
Learning Objectives: To understand managed care knowledge and practices among inner city parents
Keywords: Managed Care, Children
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.