Three-fourths of all states now have some form of Medicaid managed health care in place. This study attempts to (1) describe the benefits and barriers to quality healthcare in Medicaid managed care programs for persons with disabilities, and (2) to develop disability-related healthcare policy recommendations for Medicaid program planners. We collected data from multiple site visits and telephone interviews, in three states, using a semi-structured questionnaire. We then compiled and thematically coded this interview data to identify benefits and barriers to healthcare for persons with disabilities enrolled in Medicaid managed care plans. Case management and improved continuity of care emerged as major benefits. Problems included misunderstanding and miscommunication about regulations, covered benefits, and appeal procedures. Rural areas presented the greatest challenges for health care service delivery, access to needed medical equipment, and access to specialty care and home health services. Other challenges included lack of transportation and support services, cultural differences, and poverty. Our in-depth case studies of Medicaid managed care programs in Delaware, New Mexico and Texas identified both benefits and barriers to health care service delivery for persons with disabilities. Future Medicaid program development should address linkages to support services not covered by health plans, and should attempt to incorporate disability perspectives at all stages of program development to facilitate communication among all stakeholder groups. See www.nrhchdr.org
Learning Objectives: 1) Examine multiple perspectives on Medicaid managed health care. 2) Identify health care benefits and barriers for consumers with disabilities in Medicaid managed care plans.
Keywords: Disability, Health 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.