Aging With a Physical Disability in Medicaid Managed Care

Abstract

This study examines health services appraisal (HSA) and unmet health-care needs for adults (age 50 and over) with physical disabilities in Medicaid managed care (MMC) versus Medicaid fee for service (FFS). Surveys from 309 individuals in MMC and 349 in FFS 2 years after MMC implementation included demographics, MMC processes, HSA, and unmet health-care needs. Regression analyses with HSA and unmet health-care needs as outcomes included demographics and group status (MMC or FFS) for the entire sample, and demographics and MMC processes (continuity of care, experience with care coordinators and primary care physicians) as independent variables for only MMC enrollees. Group status was not associated with HSA or unmet needs. Among MMC enrollees, better health and more positive MMC processes related to higher HSA and lower unmet needs. It is important to consider the perspectives of people aging with disabilities in MMC to better serve their needs.

Health Service Utilization and State Costs Among Adults Aging With Early-Acquired Physical Disabilities in Medicaid Managed Care

“…For persons with early-acquired physical disabilities, Medicaid is a primary source of health services required to meet their complex health care needs, some of which may intensify as they age. Their reliance on Medicaid may make them particularly vulnerable to its changing health service delivery model (Heller, Owen, Bowers, & Gibbons, 2017). However, studies on the impact these changes have on persons with physical disabilities and their subgroups are scarce.…”

“…However, studies on the impact these changes have on persons with physical disabilities and their subgroups are scarce. Few researchers examined the health outcomes of these individuals, another goal of MMC along with those examined in the present study (Berwick, Nolan, & Whittington, 2008; Bowers et al, 2017; Heller et al, 2017). Monitoring changes in Medicaid programs at the state level and cumulating more empirical data in achieving intended goals are imperative to better understand and advocate for health care needs of this population.…”