The Medicaid program and consumer needs: a survey among residents of a poor Chicago neighborhood

A convenience sample of 200 inner-city residents were interviewed about their knowledge of benefits available under the Illinois Medicaid fee-for-service and prepaid programs; a second sample of 200 residents from the same community were interviewed about their health care information needs. All respondents were recruited from a Chicago neighborhood with one of the nation's highest rates of poverty, infant mortality, and births of low birth weight infants. The neighborhood also has been targeted as a demonstration site for an Illinois Department of Public Aid's prepaid Medicaid program. Responses to the first interview indicated that neighborhood residents did not understand the operational features of Medicaid prepaid plans or the programmatic mission of these plans, and they did not want to enroll in existing prepaid plans. As determined in the second interview, residents desired information on the scope of Medicaid services, ways to assess quality of health care received, and options for maintaining their freedom to choose hospitals and physicians or clinics. The survey findings are compared with what is known about the reasons middle class employed families enroll in and disenroll from prepaid plans and the position of poor families in a cost-conscious health care system.