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

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* Families were twice as likely to be highly satisfied in non-managed care plans
as in managed care plans with aspects of service delivery of greatest
importance-to children with special needs (% highly satisfied in HMO, PPO,
not in- managed care) such as access to a case manager or care coordinator
(25%, 29%, 59%/0), access to second opinions (27%, 39%/a, 590/6), appeals or
grievance procedures (12%, 15%, 42%), and flexibility to use cost-effective
providers (21%, 24%, 41%).
* The smallest variation in percent of families reporting high satisfaction is seen
in appropriate well child care AMMO, PPO, not in-nanaged care; 69%, 66%,
60%).
5. Responses from families not in manaeed care compared to those in two catezories
of managed care plans show a pattern of decreasing satisfaction with both services
and delivery as choice is restricted (Tables-6,11, 12 &13) For example:
* In overall evaluation of child's health plan, 63% of families not in managed
care plans gave their child's plan the highest ratings, as compared to 58% of
families in PPOs and 46% of families in HMOs.(Table 6).
* In child's health plan covers costs to meet child's needs, 53% of families not
in managed care said that their child's health plan covers costs to meet the
child's needs, as compared to 49% of families in PPOs and 41% of families in
HMOs.(Table 6)
* Respondents in managed care plans were less likely- to be "very satisfied" than
those not in a managed care plan when rating specific services. In 21 of the 27
health services categories, families not in managed care plans were more highly
satisfied than those in PPOs and HMOs. (Table 10)
* Families not in managed care gave the highest satisfaction ratings in 21 of the
25 categories of service delivery, while those in HMOs and PPOs gave the
highest ratings in only two categories each. (Table 10)
-I T most unmet needs (represented by the combination of the "not satisfied"
and."neededlnot available" responses) were reported by respondents in HMfOs
(in 16 of the 27 direct service categories) while those in PPOs indicated the
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