Medicaid families under managed care. Anticipated behavior

Area of Science:

• Health Services Research
• Public Health Policy
• Socioeconomics

Background:

• Medicaid managed care programs are expanding nationwide.
• Understanding recipient preferences is crucial for successful program implementation.
• Previous research has not fully explored pre-enrollment decision-making factors.

Purpose of the Study:

• To examine healthcare choices and decision-making among Aid to Families with Dependent Children (AFDC) eligible Medicaid clients.
• To anticipate client behavior before enrollment in a new county-wide Medicaid-managed care program.
• To identify factors influencing healthcare source selection within this population.

Main Methods:

• Household survey conducted with 495 AFDC-eligible Medicaid clients in Monroe County, New York.
• Analysis of client views on healthcare sources and reasons for preferences.
• Assessment of anticipated changes in healthcare provider affiliation.

Main Results:

• Significant ethnic differentials observed in healthcare source choice and reasons.
• Forty percent expressed a desire to change care sources, but only 13% were expected to do so.
• Private practice was the preferred source, with distance identified as a major access barrier.
• Managed care was perceived as a potential stigma-free affiliation method.

Conclusions:

• Medicaid recipient choices are rational, influenced by system knowledge and socioeconomic conditions.
• The new managed care program may address stigma concerns and improve provider affiliation.
• Findings have implications for transitioning Medicaid programs from fee-for-service to managed care/HMO models.