Online Program

Heathcare access and satisfaction: Adults with disabilities on Medicaid managed care

Tuesday, November 5, 2013

Tamar Heller, PhD, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Randall Owen, PhD, Department of Disabiltiy and Human Development, University of Illinois at Chicago, Chicago, IL
As Medicaid Managed Care (MMC) expands across states for people with disabilities, it is important to examine enrollees' access to and satisfaction with healthcare services. This study uses results from a longitudinal survey of adults with disabilities for the year prior to and the year after transitioning from fee for service to MMC in several Midwest counties. The response rate for the longitudinal survey (self or informant) was over 70%. The 181 respondents included three groups: developmental disabilities (73), mental health (35) and physical disabilities (50), and unspecified (23). Preliminary analyses did not find any significant differences in the number of medical services, equipment needs or specialist services over time. Similarly, there was no significant change in the number of preventative care services received. However, satisfaction with healthcare did decrease significantly (p=0.021). This decrease was only significant for the physical disability group (p=0.02) when the groups were compared. Our analysis suggests that the source of the decrease in satisfaction can be attributed to decreased satisfaction with primary care physicians (p=0.002 overall; p=0.044 for the mental health group), decreased satisfaction with medical services (p=0.001 overall; p=0.002 for the physical disability group), decrease in how easy it is to get an appointment with a specialist (p=0.005 overall; 0.024 for the physical disability group) and increased travel time to specialists (p=0.018 overall; p=0.022 for the developmental disability group). Qualitative data from the survey indicates problems finding doctors; difficulties obtaining dental services; and confusion about MMC, especially regarding billing.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Evaluate the impact of Medicaid managed care on healthcare access and satisfaction of people with disabilities who transition from more traditional fee for service Medicaid programs. Assess differences in various disability groups in regard to their access and satisfaction with healthcare.

Keyword(s): Disability Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am professor and head of the Department of Disability and Human Development and director of the Illinois University Center of Excellence in Developmental Disabilities and the RRTC on Lifespan Health and Function. I have lead many grants on health issues for people with disabilities.
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.