scholarly journals Aging With a Physical Disability in Medicaid Managed Care

2017 ◽  
Vol 39 (6) ◽  
pp. 778-798 ◽  
Author(s):  
Tamar Heller ◽  
Randall Owen ◽  
Anne Bowers ◽  
Hailee M. Gibbons
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Primary Care Physicians ◽  
Unmet Needs ◽  
Fee For Service ◽  
Health Care Needs ◽  
Care Needs ◽  
Group Status ◽  
Medicaid Managed Care ◽  
Unmet Health Care Needs

This study examines health services appraisal (HSA) and unmet health-care needs for adults (age 50 and over) with physical disabilities in Medicaid managed care (MMC) versus Medicaid fee for service (FFS). Surveys from 309 individuals in MMC and 349 in FFS 2 years after MMC implementation included demographics, MMC processes, HSA, and unmet health-care needs. Regression analyses with HSA and unmet health-care needs as outcomes included demographics and group status (MMC or FFS) for the entire sample, and demographics and MMC processes (continuity of care, experience with care coordinators and primary care physicians) as independent variables for only MMC enrollees. Group status was not associated with HSA or unmet needs. Among MMC enrollees, better health and more positive MMC processes related to higher HSA and lower unmet needs. It is important to consider the perspectives of people aging with disabilities in MMC to better serve their needs.

scholarly journals Perceived Met and Unmet Health-Care Needs in a Community Population with Multiple Sclerosis

2012 ◽  
Vol 14 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Scott B. Patten ◽  
Jeanne V.A. Williams ◽  
Dina H. Lavorato ◽  
David Terriff ◽  
Luanne M. Metz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Unmet Needs ◽  
Care Seeking ◽  
Health Care Needs ◽  
Supportive Services ◽  
Care Needs ◽  
Health Related ◽  
Unmet Health Care Needs ◽  
Statistics Canada

Community-based studies are required to accurately describe the supportive services needed by people with multiple sclerosis (MS). Characteristics that influence (or result from) care-seeking may introduce bias into other types of studies. The Participation and Activity Limitation Survey (PALS) was a post-census survey conducted by Statistics Canada in association with a 2006 national census. The PALS collected data from a sample of 22,513 respondents having health-related impairments according to their census forms. The survey collected self-reported diagnostic data and obtained ratings for items assessing impairment as well as perceived met and unmet needs for care and support. It identified 245 individuals with MS, leading to an estimated (weighted) population prevalence of 0.2% (200 per 100,000). As expected, those with MS reported more-severe health problems than did those with other types of disability, particularly in the areas of mobility, dexterity, and cognition; they were also more likely to report having multiple caregivers. People with MS also reported more unmet health-care needs than did those with other forms of disability, particularly with respect to meal preparation, housework, shopping, and chores. Despite their more negative health status and greater reliance on caregivers, people with MS reported participation in society comparable to that of people without MS. Thus, people with MS report greater needs than do people with other forms of health-related disability and utilize supportive services more often. However, they also report higher levels of unmet needs. The substantial needs of people with MS are only partially addressed by existing services.

scholarly journals Risk Selection among SSI Enrollees in TennCare

2002 ◽  
Vol 39 (2) ◽  
pp. 152-167 ◽  
Author(s):  
Steven C. Hill ◽  
Craig Thornton ◽  
Christopher Trenholm ◽  
Judith Wooldridge
Keyword(s):  
Managed Care ◽  
Care Program ◽  
Risk Selection ◽  
Fee For Service ◽  
Health Care Needs ◽  
Care Needs ◽  
Medicaid Managed Care ◽  
Care Plans ◽  
Alternative Measures ◽  
Selection For

The issue of risk selection is especially important for states that enroll blind and disabled beneficiaries of Supplemental Security Income (SSI) in Medicaid managed care. SSI beneficiaries have persistent needs for care, have a wide variety of chronic conditions, and often need atypical and complex services. Risk selection occurs when the health care needs of beneficiaries enrolled in a specific plan differ systematically from the needs of the overall beneficiary population and payments do not reflect those needs. We assess the extent of risk selection among managed care plans for SSI beneficiaries over the first three years of Tennessee's Medicaid managed care program, TennCare. Using claims data containing fee-for-service expenditures prior to enrollment in managed care, we find substantial evidence of persistent risk selection among plans. Results are robust to most alternative measures of risk selection for most plans.

scholarly journals Unmet Health Care Needs among Cancer Patients in Baghdad, National Centre for Cancer Diseases in 2018.

2020 ◽  
Vol 2 (1) ◽  
pp. 32-41
Author(s):  
Mustafa Majid ◽  
Sara Ahmad ◽  
Ali Abdulmortafea ◽  
Manwar Al-Naqqash
Keyword(s):  
Health Care ◽  
Cancer Patients ◽  
Medical Information ◽  
Unmet Needs ◽  
Family Doctor ◽  
Health Care Needs ◽  
Care Needs ◽  
National Centre ◽  
Unmet Health Care Needs ◽  
Cancer Diseases

Background: Identifying the unmet health care needs of cancer patients represents the first step in making health care provided to these patients better. Being able to accurately estimate the extent of these unmet needs and whether there are certain factors affecting their prevalence and distribution can give helpful information to healthcare providers guiding them on how to solve these problems. This study aims to identify the unmet health care needs and find out whether there is a possible association between theses unmet needs and some demographic factors such as age gender and occupation. Patients and Methods: A cross-sectional study was conducted on 200 cancer patients in The National Centre for cancer diseases in Baghdad selected by convenient sampling. The data was collected by interviewing patients with a preformed questionnaire (SUNS questionnaire, Access and Continuity Domain). Data was analyzed by using SPSS v20. Results: The highest prevalence of unmet needs was related to having family doctor items, while the lowest was related to having access to the patients’ medical information when planning services for them. 30.34% of a sample of patients were fully satisfied with the National Center for cancer diseases and said that there are no changes needed to be done while 17.39% complained about the unavailability of therapy at the center. Conclusion: This Study reveals that there is a low level of unmet needs among cancer patients indicating a good quality of provided care in the center with highest unmet needs for the family doctor and lowest for accessibility of health team to medical files and information. Keywords: Cancer, Unmet Needs, Health Care

Team-based primary care program for disabled people and changes in rate of unmet health care needs

2020 ◽  
Author(s):  
Jung Ae Kim ◽  
Yong-jun Choi ◽  
Myung-Seok Heo ◽  
Chun-Hee Oh ◽  
Kyung-Hwa Choi
Keyword(s):  
Health Care ◽  
Unmet Needs ◽  
Care Program ◽  
Medical Doctor ◽  
Health Care Needs ◽  
Disabled People ◽  
Care Needs ◽  
Primary Care Program ◽  
Before And After ◽  
Unmet Health Care Needs

Abstract Background Few studies have been conducted on the application of specific and practical methods, such as interventions, for reducing the unmet health care needs (UHCN) of disabled people. Objectives The study aims to evaluate the impact of the team-based primary care program (TPCP) for disabled people on UHCN. Method In 2017, we surveyed 696 disabled people who were enrolled in the TPCP at one of the 11 institutions belonging to the Korea Health Welfare Social Cooperative Federation from 2015 to 2017 to assess their unmet needs before and after enrolment. We conducted a logistic regression analysis before and after the program to evaluate the relationship between participation period and unmet needs after adjusting for physician type, gender, age, drinking, monthly income, disability type, personal assistance services and living alone. Result After using the service, the proportion of disabled people with unmet needs decreased from 42.9% to 20.4% for a medical doctor and 43.6% to 18.6% for a Korean medical (KM) doctor. After adjusting for related factors and stratifying with type of physician, the proportion of disabled people with unmet needs decreased significantly in response to the participation period for the medical doctor-involved program (P-trend < 0.001); this was not observed in the KM counterpart (P-trend = 0.6). Conclusion The TPCP for disabled people provides disease prevention, health care and health promotion activities and is crucial for solving the unmet needs.

scholarly journals Applying Fiduciary Responsibilities in the Managed Care Context

2000 ◽  
Vol 26 (2-3) ◽  
pp. 155-173
Author(s):  
Peter D. Jacobson ◽  
Michael T. Cahill
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Conflicts Of Interest ◽  
Economic Incentives ◽  
Fee For Service ◽  
Health Care Needs ◽  
Care Needs ◽  
Economic Interests ◽  
Scarce Resources ◽  
The Cost

The cost containment innovations offered by managed care have been needed corrections to the excesses of the fee-for-service health care system. Yet, implementing these innovations raises inevitable questions about conflicts of interest regarding the allocation of resources under managed care. The inherent conflict faced by physicians and health plan administrators between the health care needs of individual patients and the need to preserve scarce resources for patient populations is at issue in the managed care era. The sources of the conflict are the economic incentives that underlie the managed care revolution, such as capitated funding arrangements, limitations on referrals to specialists, bonuses and withholds. In making individual clinical decisions, physicians and administrators potentially infuse their own economic interests into the process.

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