Health Plan Effects on Patient Assessments of Medicaid Managed Care Among Racial/Ethnic Minorities

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dc.contributor.authorWeech-Maldonado, Robert
dc.contributor.authorElliott, Marc N
dc.contributor.authorMorales, Leo S
dc.contributor.authorSpritzer, Karen
dc.contributor.authorMarshall, Grant N
dc.contributor.authorHays, Ron D
dc.date.accessioned2019-08-14T14:59:29Z
dc.date.available2019-08-14T14:59:29Z
dc.date.issued2004
dc.description.abstractOBJECTIVE: To examine the extent to which racial/ethnic differences in Consumer Assessment of Health Plans Study (CAHPS) ratings and reports of Medicaid managed care can be attributed to differential treatment by the same health plans (within-plan differences) as opposed to racial/ethnic minorities being disproportionately enrolled in plans with lower quality of care (between-plan differences). DESIGN: Data are from the National CAHPS Benchmarking Database (NCBD) 3.0. Data were analyzed using linear regression models to determine the overall effects, within-plan effects, and between-plan effects of race/ethnicity and language on patient assessments of care. Standard errors were adjusted for nonresponse weights and the clustered nature of the data. PATIENTS/PARTICIPANTS: A total of 49,327 adults enrolled in Medicaid managed care plans in 14 states from 1999 to 2000. MAIN RESULTS: Non-English speakers reported worse experiences compared to those of whites, while Asian non-English speakers had the lowest scores for most reports and ratings of care. An analysis of between-plan effects showed that African Americans, Hispanic-Spanish speakers, American Indian/Whites, and White-Other language were more likely than White-English speakers to be clustered in worse plans as rated by consumers. However, the majority of the observed racial/ethnic differences in CAHPS reports and ratings of care are attributable to within-plan effects. The ratio of between to within variance of racial/ethnic effects ranged from 0.07 (provider communication) to 0.42 (health plan rating). CONCLUSIONS: The observed racial/ethnic differences in CAHPS ratings and reports of care are more a result of different experiences with care for people enrolled in the same plans than a result of racial/ethnic minorities being enrolled in plans with worse experiences. Health care organizations should engage in quality improvement activities to address the observed racial/ethnic disparities in assessments of care.
dc.description.urihttps://onlinelibrary.wiley.com/doi/full/10.1111/j.1525-1497.2004.30235.x
dc.identifierhttps://doi.org/10.13016/nppd-xbvi
dc.identifier.citationWeech-Maldonado, Robert and Elliott, Marc N and Morales, Leo S and Spritzer, Karen and Marshall, Grant N and Hays, Ron D (2004) Health Plan Effects on Patient Assessments of Medicaid Managed Care Among Racial/Ethnic Minorities. Journal of General Internal Medicine, 19. pp. 136-145.
dc.identifier.issn0884-8734
dc.identifier.otherEprint ID 491
dc.identifier.urihttp://hdl.handle.net/1903/22582
dc.subjectHealth
dc.subjectDisparities
dc.subjectPractice
dc.subjectResearch
dc.subjectCAHPS
dc.subjectconsumer assessments
dc.subjectMedicaid managed care
dc.subjectracial/ethnic disparities
dc.subjectConsumer Assessment of Health Plans Study
dc.subjectracial disparities
dc.subjectethnic disparities
dc.titleHealth Plan Effects on Patient Assessments of Medicaid Managed Care Among Racial/Ethnic Minorities
dc.typeArticle

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