Medicaid managed care: Issues for beneficiaries with disabilities

Abstract

Background: States are increasingly turning to managed care arrangements to control costs in their Medicaid programs. Historically, such arrangements have excluded people with disabilities who use long-term services and supports (LTSS) due to their complex needs. Now, however, some states are also moving this population to managed care. Little is known about the experiences of people with disabilities during and after this transition.Objective: To document experiences of Medicaid enrollees with disabilities using long-term services and supports during transition to Medicaid managed care in Kansas.Methods: During the spring of 2013, 105 Kansans with disabilities using Medicaid long-term services and supports (LTSS) were surveyed via telephone or in-person as they transitioned to managed care. Qualitative data analysis of survey responses was conducted to learn more about the issues encountered by people with disabilities under Medicaid managed care.Results: Respondents encountered numerous disability-related difficulties, particularly with transportation, durable medical equipment, care coordination, communication, increased out of pocket costs, and access to care.Conclusions: As more states move people with disabilities to Medicaid managed care, it is critically important to address these identified issues for a population that often experiences substantial health disparities and a smaller margin of health. It is hoped that the early experiences reported here can inform policy-makers in other states as they contemplate and design similar programs. Ó 2015 Elsevier Inc. All rights reserved.

Medicaid managed care and preventable emergency department visits in the United States

“…Our findings raise important considerations for state policymakers regarding their growing preference for Medicaid HMOs within Medicaid. There is some evidence that enrollment in Medicaid managed care (including Medicaid HMOs) results in increased healthcare costs and spending for Medicaid recipients and for state Medicaid programs [ 52 , 53 ]. Additionally, in most states Medicaid HMOs have been documented as having higher overhead than FFS Medicaid, so it is less expensive to administer FFS Medicaid [ 54 ].…”

Health Care Accessibility for Individuals With Disabilities: Barriers and Risk Factors Impacting Care

“…PRELIMINARY RESULTS: ACCESS BARRIERS Figure 2. Commonly cited barriers preventing access to healthcare evaluated in current literature 3,[5][6][7][8][10][11][12]15,[20][21] PRELIMINARY RESULTS: RISK FACTORS Figure 3. Commonly cited risk factors potentially resulting in healthcare disparity evaluated in current literature 3-5, 8-11,13-14,16-22.…”

Perceptions of Health and Healthcare of People With Intellectual and Developmental Disabilities in Medicaid Managed Care

“…Given that increasing numbers of people with IDD are being transitioned to MMC, it is imperative that people with IDD be included in evaluations of the impact of MMC. As Hall, Kurth, Chapman, and Shireman (2015) observed, in the context of MMC, "Little is known about the experiences of people with disabilities" (p. 130), and this dearth of knowledge is particularly true for people with IDD. The purpose of this study is to explore the perspectives of people with IDD enrolled in MMC and better understand how they perceive their personal health and their experiences with healthcare within MMC.…”