Aging With a Physical Disability in Medicaid Managed Care.

Area of Science:

• Health Services Research
• Gerontology
• Disability Studies

Background:

• Older adults with physical disabilities rely on Medicaid for healthcare.
• Medicaid Managed Care (MMC) and Fee-for-Service (FFS) are two distinct delivery systems.
• Understanding health services appraisal (HSA) and unmet needs is crucial for this population.

Purpose of the Study:

• To compare HSA and unmet health-care needs among adults aged 50+ with physical disabilities in MMC versus FFS.
• To identify factors influencing HSA and unmet needs within MMC.

Main Methods:

• Cross-sectional survey of 309 MMC and 349 FFS participants 2 years post-MMC implementation.
• Regression analyses examined the association of delivery system and MMC processes with HSA and unmet needs.
• Key variables included demographics, continuity of care, and experiences with care coordinators and primary care physicians.

Main Results:

• Delivery system (MMC vs. FFS) was not significantly associated with HSA or unmet health-care needs.
• Within MMC, better self-reported health and positive experiences with care processes (continuity, care coordinators, primary care physicians) correlated with higher HSA and fewer unmet needs.
• These findings highlight the importance of care quality within managed care settings.

Conclusions:

• The delivery model alone did not determine health services appraisal or unmet needs for this population.
• Quality of care and patient experience within Medicaid Managed Care are critical for improving health services appraisal and meeting the healthcare needs of older adults with disabilities.
• Future research should focus on optimizing care coordination and patient-centeredness in MMC programs.