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A Managed Care Model for Latino Adults With Chronic Illness and Disability

Results of the Brightwood Health Center Intervention

Boston University, Massachusetts, sbachman{at}bu.edu

Carol Tobias

Health and Disability Working Group, Boston, Massachusetts

Robert J. Master

Commonwealth Care Alliance, Boston, Massachusetts

Jeffrey Scavron

Brightwood Health Center, Springfield, Massachusetts

Katherine Tierney

Boston University, Massachusetts

The authors evaluated a managed care model developed for use by community-based providers to improve health care outcomes for low-income Latinos with disabilities and chronic illnesses. Through this model, Medicaid enrollees with special health care needs were identified and received enhanced primary care, on-site mental health and addiction services, care coordination, and support services based on their levels of need. The goal of the demonstration was to determine whether capitation would be a catalyst to transform typical primary care delivery processes to provide enhanced, culturally competent care to patients with complex health care and psychosocial needs. Despite a significant investment in outpatient services, the intervention was cost effective due to a dramatic decline in inpatient care for a few enrollees. For most enrollees, care was slightly more expensive due to enhanced outpatient medical and mental health care. Enrollees expressed high satisfaction with the intervention.

Key Words: managed care • Latino adults • chronic illness • disability

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