Impact of Medicaid Managed Care on Illinois's Acute Health Services Expenditures for Adults With Intellectual and Developmental Disabilities

2018 ◽  
Vol 56 (2) ◽  
pp. 133-146 ◽  
Author(s):  
Kiyoshi Yamaki ◽  
Coady Wing ◽  
Dale Mitchell ◽  
Randall Owen ◽  
Tamar Heller
Keyword(s):  
Developmental Disabilities ◽  
Managed Care ◽  
Health Services ◽  
Cost Savings ◽  
Intellectual And Developmental Disabilities ◽  
Fee For Service ◽  
Access To Health Services ◽  
Medicaid Managed Care ◽  
The Difference ◽  
The Impact

Abstract States have increasingly transitioned Medicaid enrollees with disabilities from fee-for-service (FFS) to Medicaid Managed Care (MMC), intending to reduce state Medicaid spending and to provide better access to health services. Yet, previous studies on the impact of MMC are limited and findings are inconsistent. We analyzed the impact of MMC on costs by tracking Illinois's Medicaid acute health services expenditures for adults with intellectual and developmental disabilities (IDD) living in the community (n = 1,216) before and after their transition to MMC. Results of the difference-in-differences (DID) regression analysis using an inverse propensity score weight (IPW) matched comparison group (n = 1,134) design suggest that there were no significant state Medicaid cost savings in transitioning people with IDD from FFS to MMC.

scholarly journals Mental healthcare and service user impact of the COVID-19 pandemic: results of a UK survey of staff working with people with intellectual disability and developmental disorders

2020 ◽  
Author(s):  
Rory Sheehan ◽  
Christian Dalton-Locke ◽  
Afia Ali ◽  
Vasiliki Totsika ◽  
Norha Vera San Juan ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disabilities ◽  
Mental Health Services ◽  
Health Services ◽  
Service User ◽  
Mental Healthcare ◽  
Free Text ◽  
Intellectual And Developmental Disabilities ◽  
Health And Social Care ◽  
The Impact

Background Very little is known about the impact of previous epidemics on the care of people with intellectual and developmental disabilities, particularly in terms of mental health services. The COVID-19 pandemic has the potential to exacerbate existing health inequalities as well as expose gaps in service provision for this vulnerable population group. Methods We investigated the responses of 648 staff working in mental healthcare with people with intellectual disabilities and/or developmental disabilities. Participants contributed to a UK-wide online survey undertaken by the National Institute for Health Research Mental Health Policy Research Unit between 22nd April and 12th May 2020. Recruitment was via professional networks, social media and third sector organisations. Quantitative data describing staff experience over three domains (challenges at work, service user and carer problems, sources of help at work) were summarised and differences between groups explored using Chi square tests. Content analysis was used to organise qualitative data focusing on service changes in response to the pandemic. Results The majority of survey respondents worked in the NHS and in community mental health services. One third had managerial responsibility. Major concerns expressed by mental healthcare staff were: difficulties for service users due to lack of access to usual support networks and health and social care services during the pandemic; and difficulties maintaining adequate levels of support secondary to increased service user need. Staff reported having to quickly adopt new digital ways of working was challenging; nevertheless, free text responses identified remote working as the innovation that staff would most like to retain after the pandemic subsides. Conclusions Understanding the experiences of staff working across different settings in mental healthcare for people with intellectual and developmental disabilities during the COVID-19 pandemic is essential in guiding contingency planning and fostering service developments to ensure the health of this vulnerable group is protected in any future disease outbreaks.

scholarly journals Perceptions of Health and Healthcare of People With Intellectual and Developmental Disabilities in Medicaid Managed Care

2016 ◽  
Vol 54 (2) ◽  
pp. 94-105 ◽  
Author(s):  
Hailee M. Gibbons ◽  
Randall Owen ◽  
Tamar Heller
Keyword(s):  
Developmental Disabilities ◽  
Managed Care ◽  
Healthcare Providers ◽  
Self Care ◽  
Good Health ◽  
Intellectual And Developmental Disabilities ◽  
Access To Services ◽  
Medicaid Managed Care ◽  
Semistructured Interviews ◽  
Spiritual Self

Abstract This study examined perceptions of health and healthcare of people with intellectual and developmental disabilities (IDD) receiving Medicaid Managed Care. Exploratory, semistructured interviews were conducted with 23 participants. Findings indicate that participants generally expressed being in good health and defined good health as (a) absence of pain, disease, and symptoms; (b) adherence to or not requiring treatment; (c) physical self-care; (d) mental or spiritual self-care; and (e) ability to perform the activities one wants to do. Participants conceptualized healthcare as (a) ensuring needs are met through access to services, (b) obtaining quality services, (c) navigating the healthcare system successfully, and (d) receiving humanizing healthcare. This study has implications for improving healthcare and communications between people with IDD and healthcare providers.

scholarly journals Medicaid Managed Care and the Health Care Utilization of Foster Children

2017 ◽  
Vol 54 ◽  
pp. 004695801769855
Author(s):  
Makayla Palmer ◽  
James Marton ◽  
Aaron Yelowitz ◽  
Jeffery Talbert
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Utilization ◽  
Foster Children ◽  
The State ◽  
Care Utilization ◽  
Fee For Service ◽  
Medicaid Managed Care ◽  
Outpatient Utilization ◽  
The Impact

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large enough to contain a sufficient number of foster children for such analysis. Using administrative Medicaid data from Kentucky, we use retrospective difference-in-differences analysis to compare the outpatient utilization of foster children transitioned to MMC in one region of the state with foster children in the rest of the state who remained in fee-for-service coverage. We find that the transition to MMC led to a 4 percentage point reduction in the probability of having any monthly outpatient utilization. We also estimate that MMC leads to a reduction in outpatient spending.

Health Service Utilization and State Costs Among Adults Aging With Early-Acquired Physical Disabilities in Medicaid Managed Care

2018 ◽  
Vol 31 (10_suppl) ◽  
pp. 97S-123S
Author(s):  
Kiyoshi Yamaki ◽  
Coady Wing ◽  
Dale Mitchell ◽  
Randall Owen ◽  
Tamar Heller
Keyword(s):  
Managed Care ◽  
Health Service ◽  
Service Use ◽  
Physical Disabilities ◽  
Fee For Service ◽  
Medicaid Managed Care ◽  
Physician Visits ◽  
Propensity Score Weight ◽  
State Expenditures ◽  
The Impact

Objective: We evaluated the impact of Medicaid managed care (MMC) on health service use and state costs among adults with early-acquired physical disabilities. Method: Using claims data, we tracked utilization of the emergency department (ED), inpatient admissions, outpatient physician visits, and state expenditures on enrollees who transitioned to MMC ( n = 881). The inverse propensity score weight and a difference-in-differences regression model were used to estimate the impact of MMC using their counterparts who remained in fee-for-service ( n = 1,552) as the comparison group. Results: MMC reduced ED use by 3.2% points/month ( p < .001). Relative to younger enrollees (age ⩽45 years), MMC reduced inpatient admissions of older enrollees (age ⩾46 years) by 3.3% points/month ( p < .001), and state expenditures by US$839/month ( p < .01). Discussion: MMC could reduce the hospital service use of and state spending on enrollees with early-acquired physical disabilities. This impact may vary depending on the enrollees’ age.

The Effects of Technology Supports on Community Grocery Shopping Skills for Students With Intellectual and Developmental Disabilities: A Meta-Analysis

2021 ◽  
pp. 016264342198997
Author(s):  
Sojung Jung ◽  
Ciara Ousley ◽  
David McNaughton ◽  
Pamela Wolfe
Keyword(s):  
Developmental Disabilities ◽  
Positive Impact ◽  
Single Case ◽  
Effect Sizes ◽  
Future Research ◽  
Intellectual And Developmental Disabilities ◽  
Positive Effects ◽  
Analytic Review ◽  
Wide Range ◽  
The Impact

In this meta-analytic review, we investigated the effects of technology supports on the acquisition of shopping skills for students with intellectual and developmental disabilities (IDD) between the ages of 5 and 24. Nineteen single-case experimental research studies, presented in 15 research articles, met the current study’s inclusion criteria and the What Works Clearinghouse (WWC) standards. An analysis of potential moderators was conducted, and we calculated effect sizes using Tau-U to examine the impact of age, diagnosis, and type of technology on the reported outcomes for the 56 participants. The results from the included studies provide evidence that a wide range of technology interventions had a positive impact on shopping performance. These positive effects were seen for individuals across a wide range of ages and disability types, and for a wide variety of shopping skills. The strongest effect sizes were observed for technologies that provided visual supports rather than just auditory support. We provide an interpretation of the findings, implications of the results, and recommended areas for future research.

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