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Online Program

332066
Longitudinal Analysis of Change in Unmet Medical Needs: The Role of Medicaid Managed Care


Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Randall Owen, PhD, Department of Disabiltiy and Human Development, University of Illinois at Chicago, Chicago, IL
Caitlin Crabb, MPH, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Anne Bowers, PhD, Dept of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Tamar Heller, PhD, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Audio (mp3) recording Recorded Presentation (mp4)
Background:  One reason to transition from fee-for-service to Medicaid Managed Care (MMC) is to increase access to healthcare, decreasing the number of unmet medical needs. This research examines the impact of transition to MMC on enrollees’ unmet medical needs longitudinally, differentiating for recent transitions to and longer term enrollees in MMC.

Methods:  The study used surveys from 334 Medicaid enrollees with disabilities collected at two points one year apart, 248 individuals who transitioned to MMC prior to T1 and 86 who received fee-for-service at T1 and transitioned to MMC immediately before T2. We conducted a regression analysis with the outcome of number of unmet medical needs at T2, and of demographics, disability type, unmet medical needs at T1, and when the person was enrolled in MMC as independent variables. Unmet needs were measured using needed/received/NA responses to a list of 18 possible medical services.

Results:  The regression showed that people who were enrolled in MMC for over one year had fewer unmet medical needs one year later. In addition, overall, people with a mental health disability (MH) had more unmet needs than people without (MH).

Conclusion:  We show that \MMC can help to reduce the number of unmet medical needs that Medicaid enrollees have over time. Members who were enrolled in MMC for over a year saw a significant decrease in the number of unmet needs. Further, this study emphasizes the importance of addressing the medical needs of people with MH, who have higher levels of unmet needs than others.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare the impact of Medicaid Managed Care (MMC) on unmet medical needs for people with disabilities by the length of time a person has been enrolled with MMC. Assess the challenges facing seniors and people with disabilities as they transition from fee-for-service (FFS) to MMC with regard to their medical needs. Identify services to which MMC has increased access, and services that need to be improved.

Keyword(s): Disabilities, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate student in Disability Studies at the University of Illinois at Chicago and have worked on the survey portion of this project for 1 year. I have conducted the statistical analyses contained in this paper and am currently completing a literature review on the topic. I have past experience working with a Managed Care Organization, although it is not a conflict for this project.
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.

Back to: 4308.0: Medicaid and Medicare Utilization and Services among People with Disabilities