264561
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
Monday, October 29, 2012
: 2:53 PM - 3:11 PM
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.
Learning Areas:
Biostatistics, economics
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Learning Objectives: 1. Describe how former-Fee For Services (FFS) patients in Medicaid rate the quality of health care services in managed care.
2. Compare former-FFS patients with disabilities to the general Medicaid population, to identify facets of health care services requiring additional adaptation.
3. Compare ratings of health care services by patients who opted into managed care, versus patients transitioned into managed care from FFS, to identify areas with special need.
4. Identify health care services for which former-FFS adults and children with disabilities, as groups, manifest different problems or needs.
5. Describe lessons learned in adapting services to accommodate incoming former-FFS patients with disabilities.
Keywords: Disability, Medicaid Managed Care
Presenting author's disclosure statement:Qualified on the content I am responsible for because: Served six years as Senior Biostatistician at the largest public health plan in the United States serving Medicaid and CHIP populations in an ethnically diverse urban county in the southwest United States. Managed CAHPS survey from 2006 to 2012 to obtain actionable information to guide the design of interventions to improve the quality of services and care. Developed and conducted survey of patients living with disabilities; and oversamples of patients with disabilities on other surveys.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
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