Medicaid Managed Care - U.S. Senate Special Committee on Aging

526
settings. Finally, plans that serve members of these groups must accommodate the
physical access and communication needs of special populations.
General Measures for Assuring Access
One of the major reasons <strong>Medicaid</strong> agencies turn to managed care is to improve and
expand access to health services. A recent study found that people with chronic
conditions among the general population often could not find a provider (11%),
services were not available when needed (19%) or they could not get to the
service(15%). 2 This situation combined with the reluctance of many providers to
serve any <strong>Medicaid</strong> beneficiary could combine to make accessing care extremely
difficult for <strong>Medicaid</strong> beneficiaries with chronic conditions.
Many of the states enrolling members of special populations into <strong>Medicaid</strong> managed
care plans are doing so, at least partially, to improve access to care for these
beneficiaries. Charts A and B3 suggest that <strong>Medicaid</strong> agencies are responding to the
needs of special
Chadt A
Natioral Academy for State Health Policy
<strong>Medicaid</strong> <strong>Managed</strong> can,
Strategies for Assuring Access
Risk-Based Coniacinsg
populations, who
have more complex
needs than other
<strong>Medicaid</strong>
[l AFDC i d *ldedy'% sN beneficiaries, and
!10% ' .2, U s 1 Riat-d 3the O access barriers
1 9
so.. _F76% some members of
7 . .
70% 66%
94% 91%
68% 68%~~~~~~60
- _ ;17 -1
9 7*
*.2
these populations
have encountered.
5% , S8% This attention may
also reflect the lack
of plan experience
20% Ctei oln cetaChoiCriAmraA serving members of
special populations.
10%
This increased
scrutiny is
particularly
0% ~ ~ ~ ~ ot~plan
apparent during the
selection
rais witiog H6 . t.. process and the use
2 Catherine Hoffman, ScD. et al, Chronic <strong>Care</strong> in Amenica: A 21st Century Challenge,
(Pninceton NJ: Robert Wood Johnson Foundation,1996).
3 All charts in this Volume are based on state-reported information from the survey that
forms the basis of volume l and reflects program status as of1June 30, 1996.
The National Academy for State Health Policy e D 8/97 IV-23