Women in New York City's Medicaid program: a report on satisfaction, access, and use

This article analyzes the experiences of women in New York City's Medicaid program regarding their satisfaction with, access to, and use of medical care during an early phase of a managed care enrollment initiative. Data for this study are from a 1994 survey of New York City Medicaid beneficiaries (1,221 women) as well as from focus group discussions. Differences in reported satisfaction levels, access, and use between managed care enrollees and conventional Medicaid beneficiaries are examined, as are differences between women in fair and poor health and those in excellent, very good, and good health. Multivariate analyses found that women enrolled in Medicaid managed care overall were significantly more likely to report greater satisfaction with access, interpersonal quality, technical skills, and arrangements for choosing a personal doctor; equivalent use; and better access compared to those in conventional Medicaid. Female managed care beneficiaries who reported worse health, however, were significantly more likely than those in better health to also report less satisfaction in 13 dimensions of medical care. Continued evaluation of Medicaid managed care is warranted, particularly as more vulnerable groups are enrolled.