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

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improve family satisfaction by working with families to develop low cost
mechanisms for effective communication with school systems.
* Over 40 % of respondents were dissatisfied with transition from adolescent to
adult services. Proactive identification of adult providers, and planning and
coordination for these transitions within plans could address this issue.
* Over 40 0 /h of respondents were dissatisfied with the flexibility to use cost
effective alternative services, equipment or providers. Case management
programs in traditional insurance plans that have allowed cost effective
alternatives to be approved in specific cases have been in effect for a number of
years. These models could be adapted to meet the needs of a wide range of
children with special needs in all kinds of plans.
* Over 40 % of respondents were dissatisfied with waiting time to approve
special services or equipment. A first approach to improving this situation
would be for plans to give families clear information on the expected waiting
times for such approvals, and how they might check on the status of their
request. Eliminating "pro forma" procedures for reviewing cases when an
ongoing need has been documented, and development of a 'long term care
plan" in which pre-approval was given for longer time frames could prove
more cost effective and efficient for the plan and more satisfactory for the
fmily.
4. Families with children not in manaeed care were considerably more satisfied than
those in manaaed care with services and service deliverv areas that are of most
importance to children with smecial needs (Table 10) For example:
* Families were twice as likely to be highly satisfied in non-managed care plans
as in managed care plans (% highly satisfied in HMO, PPO, not in managed
care) with services,-such as durable medical equipment, (35%,33%,71%)
adaptive equipment (23%, 20%, 60%), disposable medical supplies (42%,
38%, 86%), nutritional products (29%, 18%, 60%h), home nursing services
27%, 35%, 57%), personal care attendant services (31%, 20%, 67%),
emergency room services (41%, 48%, 79%)