A natural experiment in which low-income children enroll in Carolina ACCESS I, II, or III (Medicaid primary care case management programs featuring fee-for-service managed care) in 99 counties, Medicaid HMOs in Mecklenburg County, or a non-Medicaid, indemnity CHIP program will reveal whether organization and financing of health care is associated with variation in access to, and satisfaction with care. Oversampling of the Medicaid disabled category and claims analysis also permit responses to be analyzed by the children's need for health care (i.e., those with and without special needs). Confounding by family income and selection bias are impossible in these mandatory programs. Appropriate Consumer Assessment of Health Plans Survey (CAHPS) instruments permit valid comparisons among organization/financing modes. Telephone responses for 400 children in CHIP, 650 in Carolina ACCESS I, 650 in Carolina ACCESS II and III, and 600 in capitated HMOs in Mecklenburg were obtained in fall 1999 and winter 2000.
Learning Objectives: At the conclusion of the session, attendees will be able to: Articulate any differences in access to, and satisfaction with health care among low-income enrollees in several types of managed care and an indemnity plan for children; Further distinguish such differences between subgroups with and without special needs (or chronic conditions)
Keywords: Managed Care, Access
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.