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

Implications
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most unmet needs in 3 categories and those in not in managed care in 8
categories. (Table 11)
* Respondents in HMOs had the lowest satisfaction ratings in the most
categories of service delivery. In service delivery items those in HMOs
reported lowest satisfaction in 13 out of 25 categories, while those in PPOs
reported lowest satisfaction in 8 categories, and those not in managed care in 4
categories. (Table 12)
The information gathered in these surveys indicates progress toward providing
family-centered care for children with special health care needs, evidenced in high levels of
family satisfaction that their children are receiving good primary care. Over half of all
respondents in both managed care and non-managed care plans also indicated high
satisfaction that their child is receiving care from appropriate pediatric specialty providers.
Families in both non-managed care and managed care health plans also reported relatively
high satisfaction with most coverage of traditional, hospital based and "well care" services
for children with special needs. (An exception to this pattern was in emergency- room
services with which 41% of families in FIMOs and 48% of families in PPOs compared to
79% of families in non-managed care plans were highly satisfied. Table 10).
Families in all health plans, but particularly those in managed care plans, however,
indicated that they are not as satisfied with their child's coverage for many specialized
services needed by children with special needs including physical, occupational and speech
therapies, durable medical and adaptive equipment and home care including supplies.
These findings are consistent with those of our earlier Family Voices survey, although the
spread of variation in satisfaction reported was greater in this survey. In the area of service
delivery, there were strong differences in family satisfaction between families in non
managed care and managed care plans in accessing care coordinators, second opinions,
appeals and flexibility to use cost-effective providers, key services to families of children
with special needs. Since families in non-managed care plans reported significantly higher
satisfaction in all these areas, aspects of non-managed care plans should be examined