Reported Experiences with Medicaid Managed Care Models Among Parents of Children
- 286 Downloads
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.
KeywordsMedicaid Managed care Pediatrics Satisfaction Experiences
- 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.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.Children’s Medical Services (CMS). www.cms-kids.com. Accessed September 19, 2012.
- 11.Agency for Health Care Administration. (2007). Attachment II. Medicaid reform fee-for-service, provider service network model contract. http://www.fdhc.state.fl.us/Medicaid/medicaid_reform/provider/draftcontracts.shtml. Accessed January 27, 2012.
- 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.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. https://www.cahps.ahrq.gov/. Accessed January 27, 2012.
- 14.Agency for Health Care Research and Quality. (2012). CAHPS survey tools to advance patient-centered care. Rockville, MD. https://www.cahps.ahrq.gov/. Accessed January 27, 2012.
- 15.Agency for Health Care Research and Quality. (2011). CAHPS health plan survey chartbook. Rockville, MD. https://www.cahps.ahrq.gov/CAHPSIDB/Public/ChartbookOverview.aspx. Accessed January 25, 2011.
- 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. https://www.cahps.ahrq.gov/. Accessed January 25, 2012.
- 17.Long, J. S. (1997). Regression models for categorical and limited dependent variables. London: Sage.Google Scholar
- 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
- 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