Purpose: This study identifies health plan selection criteria and how disabled consumers with mobility impairments measure quality. Methods: We reviewed prior research and convened 11 focus groups to identify issues most important to people with disabilities (PWD). Focus groups consisted of working age persons with mobility impairments caused by cerebral palsy, multiple sclerosis, rheumatoid arthritis, or spinal cord injury. All people had a choice of MCOs. Results: mobility-impaired PWD use the same plan selection criteria as most people: provider attributes, covered benefits, and quality of care. However, our findings suggest PWD use different yardsticks. Coverage for DME and brand-name prescriptions are key drivers for mobility-impaired PWD in their selection of a health plan, but existing report cards do not present this information. Mobility-impaired PWD would also like HEDIS-type quality measures that look specifically at PWD, such as the rate of pap-smears or prostate exams for PWD. Surveys of mobility-impaired PWD could be a rich source of information on the performance of a health plan’s transportation service, such as reliability and availability at the time of appointments. Conclusions: A growing number of PWD are given the choice of MCOs through their employer or through Medicaid. However, little information is available which allows these PWD to be informed consumers and to select the health plan which is the best for them. Research needs to refine measurement tools and survey procedures to be statistically valid yet meaningful to PWD.
Learning Objectives: At the conclusion of the session, the participant will be able to: discuss shortcomings of commonly used health plan report cards from the perspective of people with disabilities; develop supplemental health plan measures that are meaningful to persons with disabilities; understand the health plan selection process by people with disabilities
Keywords: Disability Policy, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.