Medicaid Managed Care and Urban Poor People: Implications for Social Work

Abstract

Many state Medicaid programs are implementing managed care, and more can be expected to do so in the future. Medicaid managed care will have an important impact on Medicaid recipients and uninsured people who live in cities. It will also pose significant new challenges for hospitals, community health centers, and clinics serving these populations and for social workers practicing in these settings. Social workers need to understand the reasons for Medicaid managed care's development and phenomenal growth and its likely impact or clients, service delivery, and access to care in medically underserved urban neighborhoods. This article identifies roles for social workers in supporting clients in the transition to Medicaid managed care and advocating for policies that will improve access to care for disadvantaged urban populations.

Tackling Inequalities in Health: A Global Challenge for Social Work

“…As Law says, there are a variety of opportunities for social workers to engage at the national and local policy levels, including through research. Similarly, in the USA, Perloff (1996) has argued that social workers have the possibility not only to assist individuals to make best use of Medicaid-managed care systems, but also to advocate for access to care for disadvantaged populations.…”

Optimal immunization practices for the special supplemental nutrition program for women, infants, and children

“…4,5 For example, in Detroit, most infants enrolled in Medicaid after 1997 are covered by a Medicaid qualified health plan. To obtain preliminary insight into issues that might affect the way WIC activities help support immunizing such a population of infants from low-income families, we evaluated current practices and immunization-related outcomes in Detroit WIC clinics.…”

“…[1][2][3] However, at the same time that WIC has been promoting actions to support immunization assessments and referrals, access to health care (such as immunizations) and support services may have changed for the many WIC clients who are also on Medicaid in response to the growth of managed health care. 4,5 For example, in Detroit, most infants enrolled in Medicaid after 1997 are covered by a Medicaid qualified health plan. To obtain preliminary insight into issues that might affect the way WIC activities help support immunizing such a population of infants from low-income families, we evaluated current practices and immunization-related outcomes in Detroit WIC clinics.…”

“…Unlike that of swimming or wading pools, the quality of recreational fountain water is not routinely monitored. 4,5 In August 1997, the Boston Public Health Commission noted an increase in the number of reported shigella cases among children from a single neighborhood. An investigation was initiated to identify the source and to implement control measures.…”

Examining the Landscape of Managed Behavioral Health Care Through the Market Paradigm

“…With the recent emphasis by managed care organizations to enroll public assistance recipients, the challenge to social workers, who are more likely than psychiatrists and psychologists to treat individuals on public assistance, will be intensified (Perloff, 1996). More dollars are spent on public assistance recipients per capita for medical services than non-public assistance recipients (Keigher, 1995).…”