Journal ArticleDOI
Seniors' and People with Disabilities' Experiences with Mandatory Medicaid Managed Care in California: Populations to Target for Additional Support during Transitions
TLDR
In a survey of seniors and people with disabilities in California who moved into Medicaid managed care six-16 months previously, the majority reported neutral or positive experiences with managed care continuity, access, and quality, compared with fee-for-service.Abstract:
With more states moving people with disabilities and complex care needs into managed care, it is important to target beneficiaries for additional anticipated support before specific needs arise. In a survey of 1,521 seniors and people with disabilities in California who moved into Medicaid managed care six-16 months previously, the majority reported neutral or positive experiences with managed care continuity, access, and quality, compared with fee-for-service. Beneficiaries most likely to have negative experiences included those with poor self-rated health, functional impairment, cognitive impairment, frequent ED visits, and claims for back / osteoarthritis and cancer. Those with no specialty visits and those who had been continuously enrolled in Medicaid longer term before the transition also were more likely to report negative experiences. These populations can be targeted for assistance by health plans and Medicaid agencies. More specialty visits and longer time in Medicaid managed care also seems to improve beneficiaries' experiences.read more
Citations
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Journal ArticleDOI
Integration of Medicare and Medicaid for dually eligible beneficiaries: A focus group study examining beneficiaries' early experiences in California's dual financial alignment demonstration.
TL;DR: Focus groups with enrolled beneficiaries conducted to gather rich data about their early experiences with quality of care, access to care, and coordination of care in CMC plans and to identify recommendations for program improvement identified areas where beneficiaries noted improvement in their quality of Care, access, and coordinated care, but also areas for improvement.
Journal ArticleDOI
Beneficiaries Respond To California’s Program To Integrate Medicare, Medicaid, And Long-Term Services
TL;DR: Results showed increased satisfaction with benefits, improved ratings of quality of care, fewer acute care visits, and increased personal care assistance hours over time, but the lack of improvement in care coordination raises concerns about the implementation of the care coordination benefit, a key feature of the program.
Journal ArticleDOI
Predictors of Nursing Facility Entry by Medicaid-Only Older Adults and Persons With Disabilities in California.
Michelle J Ko,Robert Newcomer,Charlene Harrington,Denis Hulett,Taewoon Kang,Andrew B. Bindman +5 more
TL;DR: For older adults and persons with disabilities covered by Medicaid only, integration with housing and behavioral health services may be key to enabling beneficiaries to receive LTSS in noninstitutional settings.
Journal ArticleDOI
Managed Care Experiences of Medicaid Enrollees with Disabilities: A Qualitative Analysis of Consumer Survey Responses.
TL;DR: In this paper, a qualitative analysis of survey data explores service and care experiences reported by Medicaid enrollees with disabilities newly transitioned to managed care, and the results revealed salient managed care performance issues for the disabled Medicaid population.
Journal ArticleDOI
Medicaid managed care in Iowa: Experiences of older adults and people with disabilities.
TL;DR: The results of this study point to serious and persistent concerns related to access and quality of care under managed care for at least some HCBS waiver participants in Iowa, underscoring the need for a comprehensive evaluation of the program.
References
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The Case for Participatory Evaluation
J. Bradley Cousins,Lorna Earl +1 more
TL;DR: In this paper, the authors present an extension of the stakeholder-based model with a focus on enhancing evaluation utilization through primary users' increased depth and range of participation in the applied research process.
Does Managed Care Lead To Better Or Worse Quality Of Care? A survey of recent studies shows mixed results on managed care plan performance.
Robert H. Miller,Harold S. Luft +1 more
TL;DR: Miller and Luft as discussed by the authors compare the performance of health maintenance organizations (HMOs) to that of fee-for-service plans and conclude that the quality of care rendered by HMOs compared with the traditional system is significantly worse.
Journal ArticleDOI
Advancing scientific knowledge through participatory action research
TL;DR: In this article, the authors demonstrate the value of participatory action research for advancing scientific knowledge as well as for solving practical problems, and suggest that wider use of PAR can have a stimulating effect upon the future development of sociology.
Journal ArticleDOI
Evaluation of Medicaid Managed Care: Satisfaction, Access, and Use
Jane E. Sisk,Sheila Gorman,Anne Lenhard Reisinger,Sherry Glied,William DuMouchel,Margaret M. Hynes +5 more
TL;DR: In this article, a cross-sectional survey of a random sample of Medicaid beneficiaries in 5 managed care plans and in the conventional Medicaid program was conducted to evaluate the effects of managed care on Medicaid beneficiaries' satisfaction with, access to, and use of medical care during early implementation of an enrollment initiative.
Journal ArticleDOI
Specialists' and Primary Care Physicians' Participation in Medicaid Managed Care
TL;DR: Comparing specialist and primary care physician participation in California’s Medicaid fee-for-service and managed care programs finds that expansion of Medicaid managed care may decrease access to specialists because specialists were less likely to accept new Medicaid managed Care patients compared to Medicaid Fee- for-service patients.