Aging with a Physical Disability in Medicaid Managed Care

TitleAging with a Physical Disability in Medicaid Managed Care
Publication TypeConference Paper
Year of Publication2014
AuthorsHeller T, Owen R, Gibbons H, Mitchell D
Conference LocationPoster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana

Background: This study examines the health care experiences and access of people with disabilities in Medicaid receiving managed care (MC) versus those in fee for services (FFS) health care over two years

Methods:  The study uses survey data from 817 individuals (430 in MC and 387 in FFS) two years after the start of the MC initiative in addition to encounter data on health care utilization from the population of 39,653 in MC and 68,839 in FFS. The survey includes measures of health care appraisal, ease of receiving medication, and ease of using transportation. Health care utilization comprises emergency room (ER) use and days in the hospital.  Regression analyses with these outcomes included the Independent variables of age, gender, race, disability type, and enrollment in MC versus FFS.

Results:   Health care appraisal and ease of receiving medication did not differ between the MC and FFS groups. However, people with physical disabilities in MC reported a worse appraisal versus FFS, while people with a mental health disability in MC reported a better appraisal versus people in FFS (p<.05). Also, people with physical disabilities had better access to prescriptions in MC (p <.05).Transportation assistance was more positive (p <.01) for people in MC.  Both ER use and days in hospital decreased (-8% and -18%) for people in MC and increased for people in FFS (5%).

Conclusion: As MC approaches increase for Medicaid participants with disabilities it is important to assess the differential experiences of various disability groups within MC and in comparison to FFS.