Mandated managed care for blind and disabled Medicaid beneficiaries in a county-organized health system: Implementation challenges and access issues

  • Hawkinson Z
  • Frates J
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Abstract

Objectives: The challenges of Medicaid managed care organizations that serve blind and disabled members are reviewed. Beneficiary satisfaction and access to care are assessed, and access problems are identified and resolved or minimized to the greatest degree possible.; Study Design: Formative evaluation consisting of a mailed survey and follow-up telephone outreach contacts.; Patients and Methods: A written survey was sent to more than 18,000 Supplemental Security Income (SSI) beneficiary members who were blind or disabled, with 5574 recipients responding. Of these, 1981 members identified issues that warranted 2106 follow-up telephone calls.; Results: Survey responses showed that beneficiaries had limited experience with managed care and were generally satisfied with access to primary care. The healthcare system used the study findings to develop focused training programs and materials, to initiate a special needs liaison program, and to revise guidelines to simplify and standardize authorization procedures for obtaining medical supplies and repairing equipment.; Conclusions: Factors found to be associated with the success of a Medicaid managed care program serving blind and disabled beneficiaries include educating the members and providers for better understanding of managed care, incorporating collaborative service improvement activities, and documenting trends.;

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Authors

  • Z. C. Hawkinson

  • J. E. Frates

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