Maternal and Child Health Journal

, Volume 18, Issue 3, pp 544–553 | Cite as

Reported Experiences with Medicaid Managed Care Models Among Parents of Children

  • Allyson G. Hall
  • Amy Yarbrough Landry
  • Christy Harris Lemak
  • Erin L. Boyle
  • R. Paul Duncan


The proportion of children enrolled in Medicaid managed care arrangements has grown significantly over the past decade. Yet, few studies have attempted to assess differences in parental reports and ratings of care for children enrolled in different types of Medicaid managed care. We examine parental reports and ratings of care to explore whether and how patient and parent experiences vary by child health status and managed care plan type, including provider-sponsored specialized plans serving only children. Parents of children in a Florida Medicaid demonstration project in two counties over 3 years were surveyed using Consumer Assessment of Health Providers and Systems surveys (n = 2,741–11,067). Ordered logistic regression models with interaction terms were used to assess relationships between plan type, presence of chronic condition, and measures of patient experience. Parents of children enrolled in provider-sponsored plans that focus on pediatrics were more likely to provide a positive rating for their doctor, health plan, and specialty care compared to parents of children in an health maintenance organization (HMO). Parents of children with a chronic condition were less likely than parents of children without a chronic condition to provide a favorable rating of overall health care, their doctor, or health plan. The interaction term that assessed whether patient experience by plan type was impacted by the child’s health status was not statistically significant. Parents of Medicaid children may prefer provider-sponsored arrangements over HMOs. Findings can inform the future development of other integrated models of care involving provider-sponsored arrangements, such as pediatric Accountable Care Organizations and Patient-Centered Medical Homes.


Medicaid Managed care Pediatrics Satisfaction Experiences 


  1. 1.
    Landon, B. E., Schneider, E. C., Normand, S. L., Scholle, S. H., Pawlson, L. G., Epstein, A. M., et al. (2007). Quality of care in Medicaid Managed care and commercial health plans. JAMA, 298(14), 1674–1681.CrossRefPubMedGoogle Scholar
  2. 2.
    Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academy Press.Google Scholar
  3. 3.
    Ngui, E. M., & Flores, G. (2006). Satisfaction with care and ease of using health care services among parents of children with special health care needs: The roles of race/ethnicity, insurance, language, and adequacy of family-centered care. Pediatrics, 117(4), 1184–1196.CrossRefPubMedGoogle Scholar
  4. 4.
    Children’s Medical Services (CMS). Accessed September 19, 2012.
  5. 5.
    Huffman, L. C., Brat, G. A., Chamberlain, L. J., & Wise, P. H. (2010). Impact of managed care on publicly insured children with special health care needs. Academic Pediatric, 10(1), 48–55.CrossRefGoogle Scholar
  6. 6.
    Mitchell, J. B., Khatutsky, G., & Swigonski, N. L. (2001). Impact of the Oregon Health Plan on children with special health care needs. Pediatrics, 107(4), 736–743.CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell, J. M., & Gaskin, D. J. (2007). Caregivers’ ratings of access: Do children with special health care needs fare better under fee-for-service or partially capitated managed care? Medical Care, 45(2), 146–153.CrossRefPubMedGoogle Scholar
  8. 8.
    Mitchell, J. M., & Gaskin, D. J. (2004). Do children receiving Supplemental Security Income who are enrolled in Medicaid fare better under a fee-for-service or comprehensive capitation model? Pediatrics, 114(1), 196–204.CrossRefPubMedGoogle Scholar
  9. 9.
    Ganz, M. L., & Sisk, J. E. (2000). Evaluation of Medicaid managed care for children: Access and satisfaction. American Journal of Public Health, 90(12), 1947–1948.CrossRefPubMedCentralPubMedGoogle Scholar
  10. 10.
    Knapp, C., Madden, V., Sloyer, P., & Shenkman, E. (2012). Effects of an Integrated Care System on quality of care and satisfaction for children with special health care needs. Maternal and Child Health Journal, 16(3), 579–586.CrossRefPubMedGoogle Scholar
  11. 11.
    Agency for Health Care Administration. (2007). Attachment II. Medicaid reform fee-for-service, provider service network model contract. Accessed January 27, 2012.
  12. 12.
    Lemak, C. H., Landry, A. K., Bilello, L., Bell, L., & Van Wert, P. (2010). Medicaid reform organizational analyses: April 2009–March 2010: Department of Health Services Research Management and Policy at the University of Florida.Google Scholar
  13. 13.
    Agency for Health Care Research and Quality. (2010). Consumer assessment of healthcare providers and systems. Developing a CAHPS clinician and group survey to measure the medical home. Rockville, MD. Accessed January 27, 2012.
  14. 14.
    Agency for Health Care Research and Quality. (2012). CAHPS survey tools to advance patient-centered care. Rockville, MD. Accessed January 27, 2012.
  15. 15.
    Agency for Health Care Research and Quality. (2011). CAHPS health plan survey chartbook. Rockville, MD. Accessed January 25, 2011.
  16. 16.
    Agency for Health Care Research and Quality. (2008). About the item set for children with chronic conditions. Rockville, MD: Agency for Health Care Quality and Research. Accessed January 25, 2012.
  17. 17.
    Long, J. S. (1997). Regression models for categorical and limited dependent variables. London: Sage.Google Scholar
  18. 18.
    Johnson, C. E., Lemak, C. H., Hall, A. G., Harman, J. S., Zhang, J., Duncan, R. P., et al. (2010). Outsourcing administrative functions: Service organization demonstrations and Florida Medicaid PCCM program costs. J Health Care Finance, 37(1), 1–12.PubMedGoogle Scholar
  19. 19.
    Lemak, C. H., Hall, A. G., Johnson, C. E., Saxena, P., Aftuck, C., & Johnson, C. (2004). Evaluation of Florida’s Minority Physician Network (MPN) Program: Florida Center for Medicaid and the Uninsured.Google Scholar
  20. 20.
    Bethell, C. D., Read, D., Stein, R. E., Blumberg, S. J., Wells, N., & Newacheck, P. W. (2002). Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambulatory Pediatrics, 2(1), 38–48.CrossRefPubMedGoogle Scholar
  21. 21.
    Bethell, C. D., Read, D., Neff, J., Blumberg, S. J., Stein, R. E., Sharp, V., et al. (2002). Comparison of the children with special health care needs screener to the questionnaire for identifying children with chronic conditions—Revised. Ambulatory Pediatrics, 2(1), 49–57.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Allyson G. Hall
    • 1
  • Amy Yarbrough Landry
    • 2
  • Christy Harris Lemak
    • 3
  • Erin L. Boyle
    • 4
  • R. Paul Duncan
    • 5
  1. 1.Department of Health Services ResearchManagement and Policy, College of Public Health and Health ProfessionsGainesvilleUSA
  2. 2.Department of Health Services AdministrationSchool of Health Professions, University of Alabama at BirminghamBirminghamUSA
  3. 3.Department of Health Management and Policy, School of Public HealthUniversity of MichiganAnn ArborUSA
  4. 4.Health Systems AdministrationGeorgetown UniversityWashingtonUSA
  5. 5.Department of Health Services Research Management and PolicyUniversity of FloridaGainesvilleUSA

Personalised recommendations