Quality of Care for Chronic Conditions Among Disabled Medicaid Enrollees
An Evaluation of a 1915 (b) and (c) Waiver Program
Bibliographic Data
| ID | 9099303 |
|---|---|
| Authors | Martin P Wegman (0000-0002-4801-6314, University of Florida Health, corresponding author), Jill Boylston Herndon (0000-0003-4517-3776, corresponding author), Keith E Muller (corresponding author), Garth N Graham, Garth Graham (0000-0002-7054-4949, Aetna (United States)), W Bruce Vogel (corresponding author), Kimberly H Case, Kimberly Case (corresponding author), Jason A Lee (corresponding author), Matthew F Van Voorhis (Associated Press, corresponding author), Elizabeth A Shenkman, Elizabeth Shenkman (0000-0003-4903-1804, corresponding author) |
| Year | 2015 |
| Volume | 53 |
| Issue | 7 |
| Pages | 599-606 |
| Publication date | 2015-07-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000371 |
| PMID | 26035044 |
| PMCID | PMC4510474 |
| OpenAlex | W567425714 |
| Language | EN |
| References cited | 14 |
IMPORTANCE: Examining the impact of Medicaid-managed care home-based and community-based service (HCBS) alternatives to institutional care is critical given the recent rapid expansion of these models nationally. OBJECTIVE: We analyzed the effects of STAR+PLUS, a Texas Medicaid-managed care HCBS waiver program for adults with disabilities on the quality of chronic disease care. DESIGN, SETTING, AND PARTICIPANTS: We compared quality before and after a mandatory transition of disabled Medicaid enrollees older than 21 years from fee-for-service (FFS) or primary care case management (PCCM) to STAR+PLUS in 28 counties, relative to enrollees in counties remaining in the FFS or PCCM models. MEASURES AND ANALYSIS: Person-level claims and encounter data for 2006-2010 were used to compute adherence to 6 quality measures. With county as the independent sampling unit, we employed a longitudinal linear mixed-model analysis accounting for administrative clustering and geographic and individual factors. RESULTS: Although quality was similar among programs at baseline, STAR+PLUS enrollees experienced large and sustained improvements in use of β-blockers after discharge for heart attack (49% vs. 81% adherence posttransition; P<0.01) and appropriate use of systemic corticosteroids and bronchodilators after a chronic obstructive pulmonary disease event (39% vs. 68% adherence posttransition; P<0.0001) compared with FFS/PCCM enrollees. No statistically significant effects were identified for quality measures for asthma, diabetes, or cardiovascular disease. CONCLUSION: In 1 large Medicaid-managed care HCBS program, the quality of chronic disease care linked to acute events improved while that provided during routine encounters appeared unaffected
Asthma · Chronic care · Chronic disease · Disease · Disease management · Family medicine · Health care · Managed care · Medicaid · Medicaid managed care · Physical therapy · Quality of life (healthcare) · Chronic Disease Management Strategies · Emergency Medicine · Geriatric Care and Nursing Homes · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology
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Association of Health Plans' Healthcare Effectiveness Data and Information Set (Hedis) Performance With Outcomes of Enrollees With Diabetes
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Comparison of Resource Utilization for Medicaid Dementia Patients Using Nursing Homes Versus Home and Community Based Waivers for Long-Term Care
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| Citation velocity | historical |
|---|---|
| Highly cited | No |