Medicaid managed care and racial differences in satisfaction and access

Area of Science:

• Health Services Research
• Minority Health
• Health Disparities

Background:

• Concerns exist regarding managed care's impact on healthcare access and quality for minority populations.
• Limited empirical data currently addresses these concerns.
• This study investigates the effects of managed care on healthcare access for African Americans.

Purpose of the Study:

• To evaluate the impact of managed care implementation on healthcare access for African Americans.
• To compare healthcare access and satisfaction between managed care and fee-for-service systems.
• To determine if race influences healthcare access within different healthcare delivery systems.

Main Methods:

• A cross-sectional and longitudinal study design was employed.
• Medicaid recipients in two counties were surveyed at two time points.
• One county transitioned to managed care between survey periods.

Main Results:

• Managed care implementation did not significantly alter African Americans' access to healthcare services, neither absolutely nor relative to whites.
• Race was not associated with patient satisfaction.
• A recipient's race negatively impacted access to services in both managed care and fee-for-service settings.

Conclusions:

• Managed care, in this context, did not exacerbate or alleviate existing disparities in healthcare access for African Americans.
• Racial disparities in healthcare access persist regardless of the healthcare delivery system (managed care or fee-for-service).
• Further research is needed to understand and address the root causes of race-based disparities in healthcare access.