Online Program

332081
Impact of Care Coordination on Unmet Medical Needs and Health Service Appraisal on People with Mental Health Disabilities in Medicaid Managed Care


Monday, November 2, 2015

Anne Bowers, PhD, Dept of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Randall Owen, PhD, Department of Disabiltiy and Human Development, University of Illinois at Chicago, Chicago, IL
Tamar Heller, PhD, Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Background: Care Coordination is a fundamental component of managed care that is expected to improve healthcare for enrollees. This study asks, “What is the impact of various features of Care Coordination on unmet medical needs and health service appraisal of Medicaid Managed Care enrollees with mental health disabilities?”

Methods:  The study uses survey data from 306 adults with mental health issues receiving Medicaid Managed Care in one Midwestern state. Independent variables in the analyses include

  • Care Coordination features (Managed Care Organization affiliation, coordinator knowledge of medical history, honoring enrollee wishes for care, frequency of contact, enrollee input in care planning);
  • care continuity;
  • having multiple disabilities; and
  • demographics (age, gender, race).

Linear regression analyses were conducted for number of unmet medical needs and Health Service Appraisal outcomes. Unmet needs were measured using needed/received/NA responses to a list of 18 possible medical services.

Results:  Significant predictors of both Health Service Appraisal and unmet needs included the following variables: multiple disabilities, exposure to care continuity, and coordinator knowledge of enrollee medical history.   Significant predictors of Health Service Appraisal included Medicaid Managed Care organizational affiliation and coordinators honoring enrollee wishes for their medical care.  Lower coordinator contact frequency and minority status were significant predictors of higher enrollee unmet needs.

Conclusion: As Medicaid Managed Care delivery models are refined, this study demonstrates that specific features of the Care Coordination process are especially important to consider and prioritize to meet the needs of enrollees with mental health disabilities and ensure consumer satisfaction with services.  More research is needed in order to support coordinator performance and allow for innovation in these areas.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the impact of various features of care coordination on unmet medical needs and health service appraisal of Medicaid Managed Care (MMC) enrollees with mental health (MH) disabilities. Discuss the importance of the care coordination role and process for persons with mental health disabilities in the Medicaid population. Compare the impact of care coordination features on people with mental health disabilities in the Medicaid population.

Keyword(s): Mental Health, Managed Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am doing my dissertation on the topic of care coordination and mental health; this research is in direct relation to my degree objectives. I have worked on the survey research portion of this program evaluation project for three years from which this data was collected.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.