As increasing numbers of American Indians move into managed care, challenges remain to provide Indians with equitable amounts of medical care for improving health. Equity in government funding of managed care for Indians requires closing gaps. This study is designed to compare utilization and expenditures for Medicaid-eligible Indians with a comparable group of non-Indians in California. The study uses a unique database of FFY 96 Medicaid eligibility and paid-claims files to obtain eligibility, utilization, and cost data on American Indians who were also Indian Health Service users (n=10,317). A comparison group of non-Indian whites were matched to these Indians (n=20,416). We analyzed claims for service utilization and monthly payments per user and eligible. We will use multivariate regression analyses to determine how the differences in expenditures depend on differences in services and providers used by the two groups. Fewer Medicaid-eligible Indians used health care and users received lower payments than their counterparts. Some 26% of eligible Indians used a covered service per month, while 33% of eligible non-Indians used such services. Medicaid paid on average $146 per month per Indian, however they paid $304 per month per non-Indian. We are now modeling how these differences depend on the services and providers that the two groups use. Medicaid in California needs to increase the amount it spends on health care for Indians to achieve equity with non-Indians. The extent to which access, volume, mix and payments for services need to improve will be quantified when the analysis is completed.
Learning Objectives: By the end of the presentation, the participant will understand that Medicaid in California needs to increase the amount it spends on health care for Indians.
Keywords: Access and Services, Utilization
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.