265623 Emerging Medicaid managed care models and parental reports of their children's care

Monday, October 29, 2012 : 11:10 AM - 11:30 AM

Allyson Hall, PhD , College of Public Health & Health Professions, University of Florida, Gainesville, FL
Amy Yarbrough Landry, PhD , Health Services Administration, University of Alabama, Birmingham, Birmingham, AL
Christy Harris Lemak, PhD , Health Management and Policy, University of Michigan, Ann Arbor, MI
R. Paul Duncan, PhD, MS , Department of Health Services Research, Management, & Policy, University of Florida, Gainesville, FL
Children in Florida Medicaid's managed care demonstration program must enroll in one of three forms of managed care: traditional HMOs, provider service networks (PSNs), and a pediatric only plan (POP) PSN for children with special health care needs. The PSNs may have better reports of care compared to HMOs since they are locally owned, paid based on fee for service, and have implemented a variety of programs aimed at improving the health care experience, especially within the POP plan The objective of this study is to determine if there are differences in parental reports and ratings of care by health plan type and whether the child has a chronic condition. The study consists of an analysis of 3 years of parent satisfaction surveys in 5 counties in Florida (n=10,000). Ordered logit was used to determine the likelihood of providing higher ratings and reports of care by plan type and presence of a chronic condition. Compared to HMOs, parents whose children were enrolled in PSN or POP were statistically significantly more likely to report higher ratings of care. PSN parents had higher odds of providing a 9 or 10 rating (compared to lower ratings) of their doctor and health plan and were more likely to report no problems finding personal doctor. PSN parents were more likely to say that they always got the help/advice needed and the prescriptions they needed. POP parents were also more likely to provide higher ratings of their health plans and specialty care, to report never a problem getting an appointment with a specialist, and that it was always easy to get prescriptions compared to HMO parents. Parents of children with a chronic condition had lower odds of a having a favorable report or higher rating of care, even within the POP plan. Findings indicate that POP and PSN parents tend to report higher ratings and reports of care. In addition, while parents of sicker children were less satisfied, having a chronic condition did not further exacerbate the lower satisfaction ratings and reports among HMO parents. Plan characteristics can have an impact on patient satisfaction with care, a key indicator of quality. Some forms of Medicaid managed care are preferred over other forms. Medicaid programs should consider adopting elements of the PSN model in their managed care arrangements.

Learning Areas:
Provision of health care to the public

Learning Objectives:
1. Define organizational differences among Medicaid managed care plans in Florida 2. Identify the differences in parental reports of health care experiences across Medicaid managed care plan types. 3. Explain policy implications of differences in parental satisfaction with care across Medicaid managed care plan types.

Keywords: Medicaid Managed Care, Children

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD trained health services researcher. I have served as an investigator or principal investigator on studies on Medicaid, health care access, and medical homes.
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.