Access, satisfaction, and utilization in two forms of Medicaid managed care

Wally R. Smith; J. James Cotter; Donna K. McClish; Viktor E. Bovbjerg; Louis F. Rossiter

doi:10.1108/14664100010351297

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British Journal of Clinical Governance

ISSN: 1466-4100
Currently published as: Clinical Governance: An International Journal
Incorporates: Clinical Performance and Quality Healthcare

Online from: 1996

Subject Area: Health Care Management/Healthcare

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Access, satisfaction, and utilization in two forms of Medicaid managed care

Document Information:
Title:	Access, satisfaction, and utilization in two forms of Medicaid managed care
Author(s):	Wally R. Smith, (Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA), J. James Cotter, (Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA), Donna K. McClish, (Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA), Viktor E. Bovbjerg, (Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA), Louis F. Rossiter, (Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, USA)
Citation:	Wally R. Smith, J. James Cotter, Donna K. McClish, Viktor E. Bovbjerg, Louis F. Rossiter, (2000) "Access, satisfaction, and utilization in two forms of Medicaid managed care", British Journal of Clinical Governance, Vol. 5 Iss: 3, pp.150 - 157
Keywords:	Customer satisfaction, Health, Health care, Insurance
Article type:	General review
DOI:	10.1108/14664100010351297 (Permanent URL)
Publisher:	MCB UP Ltd
Abstract:	We determined access and satisfaction of 2,598 recipients of Virginia’s Medicaid program, comparing its health maintenance organizations (HMOs) to its primary care case management (PCCM) program. Positive responses were summed as sub-domains either of access, satisfaction, or of utilization, and adjusted odds ratios were calculated for HMO (vs. PCCM) sub-domain scores. The response rate was 47 per cent. We found few significant differences in perceived access, satisfaction, and utilization. Both HMO adults and children more often perceived good geographic access (adults, OR, [CI] = 1.50, [1.04-2.16]; children, OR, [CI] = 1.773 [1.158, 2.716]). But HMO patients less often reported good after-hours access (adults, OR, [CI] = 0.527 [0.335, 0.830]; children, OR, [CI] = 0.583 [0.380, 0.894]). Among all patients reporting poorer function, HMO patients more often reported good general and preventive care (OR, [CI] = 2.735 [1.138, 6.575]). We found some differences between Medicaid HMO versus PCCM recipients’ reported access, satisfaction, and utilization, but were unable to validate concerns about access and quality under more restrictive forms of Medicaid managed care.