<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>10</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Crabb, C.</style></author><author><style face="normal" font="default" size="100%">Bowers, A</style></author><author><style face="normal" font="default" size="100%">Owen, R.</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Appraisal of Personal Support Workers by Medicaid Managed Care Enrollees Aging with Disabilities</style></title><secondary-title><style face="normal" font="default" size="100%">American Public Health Association Annual Meeting and Expo</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year></dates><language><style face="normal" font="default" size="100%">eng</style></language></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Bowers, Anne</style></author><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Care coordination experiences of people with disabilities enrolled in medicaid managed care.</style></title><secondary-title><style face="normal" font="default" size="100%">Disabil Rehabil</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2016 Aug 22</style></date></pub-dates></dates><pages><style face="normal" font="default" size="100%">1-8</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;PURPOSE: To understand the impact of experience and contacts with care coordinators on Medicaid Managed Care (MMC) enrollees with disabilities. METHOD: Primary data was collected from a random sample of 6000 out of the 100,000 people with disabilities enrolled in one state&amp;#39;s mandatory MMC program. Surveys were conducted through the mail, telephone, and Internet; 1041 surveys were completed. The sample used for analysis included 442 MMC enrollees who received care coordination. Regression analyses were conducted with the outcomes of number of unmet health care needs and enrollee appraisal of the health services they received. Race, age, gender, and disability variables controlled for demographic differences, and the independent variables included enrollee experience with a care coordinator (coordinator knowledge of enrollee medical history and whether the coordinator took into account enrollee wishes and input) and frequency of contact with a care coordinator. RESULTS: Positive enrollee experiences with care coordinators significantly related to more positive enrollee health service appraisals and fewer unmet health care needs; frequency of contact did not have any significant impacts. People with mental health disabilities and intellectual/developmental disabilities had significantly lower health service appraisals. People with mental health disabilities had significantly more unmet needs. CONCLUSIONS: Quality of care coordination, but not frequency of contact alone, is associated with better health outcomes for MMC enrollees. Implications for rehabilitation Care coordination is a core component of managed care and facilitates effective healthcare management for people with complex chronic conditions and disabilities. Better experiences with care coordinators is related to fewer unmet healthcare needs and more positive health care service appraisals for Medicaid managed care enrollees. The continuous development of person-centered care coordination strategies and training programs emphasizing quality relationships between coordinators and consumers should be prioritized.&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>10</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Bowers, A</style></author><author><style face="normal" font="default" size="100%">Crabb, C.</style></author><author><style face="normal" font="default" size="100%">Owen, R.</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Experiences of Medicaid Enrollees with Disabilities in the Transition to Managed Care: Qualitative Analysis of Consumer Survey Responses</style></title><secondary-title><style face="normal" font="default" size="100%">American Public Health Association Annual Meeting and Expo</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year></dates><language><style face="normal" font="default" size="100%">eng</style></language></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>10</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Crabb, C.</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The impact of family input and involvement on health and long-term services and supports appraisals and unmet needs of older adults and adults with disabilities enrolled in Medicaid managed care</style></title><secondary-title><style face="normal" font="default" size="100%">Annual Meeting of the Gerontological Society of North America</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year></dates><language><style face="normal" font="default" size="100%">eng</style></language></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Bowers, Anne</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Health services appraisal and the transition to Medicaid Managed Care from fee for service.</style></title><secondary-title><style face="normal" font="default" size="100%">Disabil Health J</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Disabil Health J</style></alt-title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2015 Oct 24</style></date></pub-dates></dates><language><style face="normal" font="default" size="100%">ENG</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;BACKGROUND: Many states are transitioning fee-for-service (FFS) Medicaid into Medicaid Managed Care (MMC) for people with disabilities. OBJECTIVE: This study examined managed care&amp;#39;s impact on health services appraisal (HSA) and unmet medical needs of individuals with disabilities receiving Medicaid. Key questions included 1) Do participant demographics and enrollment in MMC impact unmet medical needs and HSA? 2) Within MMC, do demographics and continuity of care relate to unmet medical needs? 3) Within MMC, do demographics, unmet medical needs and continuity of care relate to HSA? METHODS: We collected cross-sectional survey data (n&amp;nbsp;=&amp;nbsp;1615) from people with disabilities in MMC operated by for-profit insurance companies (n&amp;nbsp;=&amp;nbsp;849) and a similar group remaining in FFS (n&amp;nbsp;=&amp;nbsp;766) in one state. Regression analyses were conducted across these groups and within MMC only. RESULTS: Across Medicaid groups, MMC enrollment was not related to either HSA or unmet needs; health status, having a mental health disability and unmet transportation needs related to HSA and health status, unmet transportation needs and having a mental health or physical disability related to higher unmet medical needs. Within MMC, in addition to better health and fewer unmet medical needs, less continuity of care significantly decreased HSA. Higher unmet transportation needs, poorer health status, having a physical or mental health disability, and less continuity of care significantly decreased unmet medical needs. CONCLUSIONS: This research points to the importance of meeting unmet needs of individuals in MMC and the need for increased continuity of care as people transition from FFS.&lt;/p&gt;
</style></abstract><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/26632026?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>47</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Gibbons, H</style></author><author><style face="normal" font="default" size="100%">Mitchell, D</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Aging with a Physical Disability in Medicaid Managed Care</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><pub-location><style face="normal" font="default" size="100%">Poster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; 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&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;&amp;nbsp; 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. &amp;nbsp;Regression analyses with these outcomes included the Independent variables of age, gender, race, disability type, and enrollment in MC versus FFS.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt;&amp;nbsp; &amp;nbsp;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&amp;lt;.05). Also, people with physical disabilities had better access to prescriptions in MC (p &amp;lt;.05).Transportation assistance was more positive (p &amp;lt;.01) for people in MC. &amp;nbsp;Both ER use and days in hospital decreased (-8% and -18%) for people in MC and increased for people in FFS (5%).&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: 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.&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>47</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Bowers, A</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Impact of Medicaid Managed Care on Health Services Appraisal and Access of Adults with Disabilities</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><pub-location><style face="normal" font="default" size="100%">Poster presented at Gerontological Society of America’s (GSA) Annual Scientific Meeting, Washington DC</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; 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&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;&amp;nbsp; 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. &amp;nbsp;Regression analyses with these outcomes included the Independent variables of age, gender, race, disability type, and enrollment in MC versus FFS.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt;&amp;nbsp; &amp;nbsp;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&amp;lt;.05). Also, people with physical disabilities had better access to prescriptions in MC (p &amp;lt;.05).Transportation assistance was more positive (p &amp;lt;.01) for people in MC. &amp;nbsp;Both ER use and days in hospital decreased (-8% and -18%) for people in MC and increased for people in FFS (5%).&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: 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.&lt;/p&gt;
</style></abstract></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>47</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Owen, Randall</style></author><author><style face="normal" font="default" size="100%">Bowers, A</style></author><author><style face="normal" font="default" size="100%">Heller, Tamar</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Unmet Needs and Health Services Appraisal: The Role of Disability Type and Service Delivery Approach.</style></title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><pub-location><style face="normal" font="default" size="100%">Poster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana</style></pub-location><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; This study examines unmet needs for and appraisal of health services for people with disabilities in Medicaid receiving managed care (MC) versus fee-for-service (FFS) service delivery approaches by disability type.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt;&amp;nbsp; The study uses survey data from 817 individuals receiving Medicaid in a Midwestern state. The disability type splits people into groups corresponding to their Medicaid waiver: intellectual/developmental (IDD, 193 respondents), physical (PD, 279), and mental health (MH, 198) disabilities and a group who don&amp;rsquo;t fit those groups (Other, 143). The delivery approach identifies people as receiving MC or FFS. &amp;nbsp;The survey measures health care appraisal and total unmet needs. A two-way ANOVA for those two outcomes with disability type and delivery approach as independent variables was followed by regressions including age, gender, race, disability, and delivery approach as independent variables.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Both health appraisal and unmet needs are significantly related to disability group but not with delivery approach. For unmet needs, other (1.59) and PD (2.19) have significantly (p&amp;lt;.05) fewer unmet needs than MH (3.16) and IDD (3.37). However, for health appraisal, only the other group had significantly (p&amp;lt;.05) higher ratings than ID or MH. Results of regression analyses show that unmet needs is negatively related (p&amp;gt;.01) to health appraisal and unmet needs is higher for people with physical and mental health disabilities (p&amp;lt;.01) than for people without those conditions.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: Unmet needs are important for health plans (MC or FFS) to address. These results specify for which disability types unmet needs are highest so healthcare providers can address them.&lt;/p&gt;
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