HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kane, R. L. Articles by Siadaty, M. S. Search for Related Content PubMed PubMed Citation Articles by Kane, R. L. Articles by Siadaty, M. S.

Outcomes of Managed Care of Dually Eligible Older Persons

Correspondence: Address correspondence to Robert L. Kane, MD, University of Minnesota School of Public Health, Mayo Mail Code 197, Minneapolis, MN 55455. E-mail: kanex001{at}umn.edu

Purpose: To assess changes in various functional and satisfaction measures between older persons enrolled in Minnesota Senior Health Options (MSHO), a managed care program for older persons eligible for both Medicare and Medicaid. Design and Methods: We used two sets of matched controls for MSHO enrollees and their families and matched controls living in the community and in nursing homes: Persons in the same county who were eligible to enroll but did not enroll in MSHO and persons in other metropolitan areas where MSHO is not available. For the community sample, we used questionnaires to measure functional status (activities of daily living), pain, unmet care needs, satisfaction, and caregiver burden. Approximately 2 years after the first survey, we resurveyed respondents who lived in the community at the time of the first survey. For the nursing home residents, we used annual assessments to calculate case mix to compare changes in functional levels over time. Results: There were few significant differences in change over time between the MSHO sample and the two control groups. Out-of-area controls showed greater increases in pain but in-area controls showed less interference from pain. Compared with out-of-area controls, MSHO clients showed greater increase in homemaker use, meals on wheels, and outpatient rehabilitation. Compared with in-area controls, they showed more use of meals on wheels and less help from family with household tasks. There were few differences in satisfaction, but the MSHO families showed significantly lower burden than controls on five items. Implications: The analyses show only modest evidence of benefit from MSHO compared with the two control groups. The model represented by MSHO does not appear to generate substantial differences in outcomes across function, satisfaction, and caregiver burden.

Key Words: Dual eligibles • Managed care • Medicare • Medicaid

This article has been cited by other articles:

				D. C. Grabowski The Cost-Effectiveness of Noninstitutional Long-Term Care Services: Review and Synthesis of the Most Recent Evidence Med Care Res Rev, February 1, 2006; 63(1): 3 - 28. [Abstract] [PDF]

				R. L. Kane, P. Homyak, B. Bershadsky, T. Lum, S. Flood, and H. Zhang The Quality of Care Under a Managed-Care Program for Dual Eligibles Gerontologist, August 1, 2005; 45(4): 496 - 504. [Abstract] [Full Text] [PDF]

				M. Lynch, C. L. Estes, and M. Hernandez Chronic Care Initiatives for the Elderly: Can They Bridge the Gerontology-Medicine Gap? Journal of Applied Gerontology, April 1, 2005; 24(2): 108 - 124. [Abstract] [PDF]

				E. A. Miller and W. G. Weissert Managed Care for Medicare-Medicaid Dual Eligibles: Appropriateness, Availability, Payment, and Policy Journal of Applied Gerontology, December 1, 2004; 23(4): 333 - 348. [Abstract] [PDF]