308798
Contrasting quality of health care services for adults and children in an evolving health care market: Findings from CAHPS surveys of adults and parents of pediatric and CSHCN patients in a large and diverse urban Medicaid health plan, 2006 to 2013
(1) Background: The above challenge is particularly serious for Medicaid health plans, due to the populations that are eligible for Medicaid due to low income: pediatric patients in households near the poverty line, in the same health care organizations as the indigent elderly and adult patients with disabilities.
(2) Objective: To compare the quality of health care services received by children versus adults in a Medicaid population; and compare services for the sickest children compared to other children, to guide improvements in services.
(3) Methods: The briefing reports results from analysis of CAHPS patient experience survey data in a large, diverse, Medicaid health plan, pooled from 2006 to 2013 (n=5,931 adults and responses for n=6,099 pediatric patients and n=2,847 children with chronic conditions (CCC) identified through the CSHCN screener). The survey rates the quality of services in a complex and dispersed provider network in excess of 5,000 physicians, on 9 broad domains of care.
(4) Findings: Initial findings indicate relatively higher ratings of services received by children, than by adults in this Medicaid population. However, comparison of CCC children to peers, reveals some areas where reported quality of services is worse for sicker children.
(5) Discussion: The briefing will discuss reasons for those findings, and the policy implications as health care reforms bring more adults into Medicaid health plans.
Learning Areas:
Biostatistics, economicsConduct 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
Learning Objectives:
Describe how Medicaid eligibility policy impacts the provider networks designed to serve children and adults.
Compare how quality of care scores differ for children versus adults, in Medicaid, and possible reasons why.
Compare how quality of care scores differ for CSHCN children versus other children.
Assess how adult and child scores differ across demographic groups.
Differentiate between geographical areas within a large urban county on measures of quality, and note healthographic implications.
Assess differences in health plans’ performance on measures of access and quality of services for children.
Describe how commonly-available surveys can be used to guide the design of programs to improve quality of care.
Discuss implications of the findings for the adaptation of health care organizations under ongoing health care reforms.
Keyword(s): Children With Special Needs, Quality of Care
Qualified on the content I am responsible for because: Served eight years as Senior Biostatistician at the largest public health plan in the United States, serving Medicaid and Medicare populations in an ethnically diverse urban county in the southwest United States. Mothers and children are the largest sub-population in the health plan. Oversaw the CAHPS patient experience survey program, including analysis of the quality of services for pediatric patients, and focused analysis of children with chronic conditions."
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.