001416639 001__ 1416639
001416639 005__ 20230306081540.0
001416639 022__ $$a1132-0559
001416639 02470 $$2Handle$$ahttp://hdl.handle.net/20.500.12419/440
001416639 037__ $$aIR
001416639 041__ $$aeng
001416639 245__ $$aEmpowered and disempowered voices of low-income people with disabilities on the initiation of government-funded, managed health care
001416639 260__ $$bCenter for Open Science
001416639 269__ $$a2014
001416639 300__ $$a9 p.
001416639 336__ $$aArticle
001416639 520__ $$aThe health and healthcare of vulnerable populations is an international concern. In 2011, a Midwestern state within the U.S. mandatorily transitioned 38,000 Medicaid recipients from a fee-for-service system into a managed care program in which managed care companies were contracted to provide recipients’ healthcare for a capitated rate. In addition to cost savings through reductions in preventable and unnecessary hospital admissions, the goals of the managed care program (MCP) included: (1) access to a more functional support system, which can support high and medium risk users in the development of care plans and coordination of care, and (2) choice among competent providers. The population transitioned was a high-need, high-cost, low-income, and low-power group of individuals. The evaluation research team used focus groups as one of many strategies to understand the experience of users during the first two years of this complex change effort. The article explores empowerment in terms of users and their family caregivers’ ability to make meaningful choices and access resources with regard to their healthcare. Specifically, factors empowering and disempowering users were identified within three thematic areas: (1) enrollment experiences, (2) access to care and (3) communication with managed care organizations and providers. While the change was not optional for users, a disempowering feature, there remained opportunities for other empowering and disempowering processes and outcomes through the transition and new managed care program. The results are from 74 participants: 65 users and 9 family caregivers in 11 focus groups and six interviews across two waves of data collection. MCP users felt disempowered by an initial lack of providers, difficulty with transportation to appointments, and challenges obtaining adequate medication. They felt empowered by having a choice of providers, good quality of transportation services and clear communication from providers and managed care organizations. Recommendations for increasing prospects for the empowerment of healthcare users with disabilities within a managed care environment are presented.
001416639 536__ $$oIllinois Department of Public Health
001416639 6531_ $$amanaged care
001416639 6531_ $$asocial sciences::psychology
001416639 6531_ $$amarginalized group
001416639 6531_ $$adisability
001416639 6531_ $$ahealthcare policy
001416639 7001_ $$aMcAuliff, Kathleen$$uUniversity of Southern Indiana
001416639 7001_ $$aViola, Judah$$uUniversity of Southern Indiana
001416639 7001_ $$aKeys, Christopher$$uUniversity of Southern Indiana
001416639 7001_ $$aBack, Lindsey T.$$uUniversity of Southern Indiana
001416639 7001_ $$aWilliams, Amber E.$$uUniversity of Southern Indiana
001416639 7001_ $$aSteltenpohl, Crystal N.$$uUniversity of Southern Indiana
001416639 773__ $$tPsychosocial Intervention
001416639 8564_ $$yArticle$$93a6869b5-ace4-4405-9e36-01dc7af2367c$$s238986$$uhttps://library.usi.edu/record/1416639/files/Empowered%20and%20disempowered%20voices%20of%20low-income%20people%20with%20disabilities%20on%20the%20initiation%20of%20government-funded%2C%20managed%20hea.pdf
001416639 904__ $$a2020-01-15T16:13:50Z$$baccessioned
001416639 904__ $$a2020-01-15T16:13:50Z$$bavailable
001416639 904__ $$a2020-01-15T16:13:50Z$$bdateFOA
001416639 904__ $$a2014$$bdateFirstOnline
001416639 905__ $$a/collection_2/1/dublin_core.xml
001416639 909CO $$ooai:library.usi.edu:1416639$$pGLOBAL_SET
001416639 980__ $$aMANUSCRIPT