Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here to sign up for SAGE Journal Email Alerts today!

Sign In to gain access to subscriptions and/or personal tools.
Journal of Disability Policy Studies
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Bachman, S. S.
Right arrow Articles by Tierney, K.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

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

Results of the Brightwood Health Center Intervention

Sara S. Bachman

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

References

  • Agency for Healthcare Research and Quality. ( 2004). National healthcare disparities report: Summary Retrieved July 12, 2004, from http://www.ahrq.gov/qual/nhdr03/nhdrsum03.htm
  • Commonwealth Fund. (2001). Diverse communities, common concerns: Assessing health care quality for minority Americans—Findings from the Commonwealth Fund 2001 Health Care Quality Survey. New York: Author.
  • Councilman, D.L. (1999). Caring for adults with mental disabilities. Post Graduate Medicine, 106(6), 181.
  • DeJong, G. (1997). An overview of the problem American Journal of Physical and Medical Rehabilitation, 76(Suppl.), S2—S8.
  • Ellwood, M., & Kell, M. (2003). Using MSIS data to analyze Medicaid eligibility and managed care enrollment patterns in 1999. Washington, DC: Mathematica Policy Research.
  • Fernandez, A., Schillinger, D., Grumbach, K., Rosenthal, A., Stewart, A.L., Wang, F., et al. (2004). Physician language ability and cultural competence. Journal of General Internal Medicine, 19, 167—174.[CrossRef][Medline] [Order article via Infotrieve]
  • Garrett, B., Davidoff, A.J., & Yemane, A. (2003). Effects of Medicaid managed care programs on health services access and use. Health Services Research, 38, 575—594.[CrossRef][Medline] [Order article via Infotrieve]
  • Gold, M., Nelson, L., Brown, R., Ciemnecki, A., Aizer, A., & Docteur, E. (1997). Disabled Medicare beneficiaries in HMOs. Health Affairs, 16(5), 149—162.[Abstract]
  • Hines, J. (2000). Communication problems of hearing-impaired patients. Nursing Standard, 14(19), 33—37.
  • Iezzoni, L.I., Davis, R.B., Soukup, J., & O'Day, B. (2002). Satisfaction with quality and access to health care among people with disabling conditions. International Journal for Quality in Health Care, 14(5), 369—381.[Abstract/Free Full Text]
  • Kirby, D.L., O'Keefe, J.S., Neal, J.G., et al. (1996). Does the architectural design of burn centers comply with the Americans With Disabilities Act? Journal of Burn Care and Rehabilitation 17, 156—160.[CrossRef][Medline] [Order article via Infotrieve]
  • Master, R.J. (1998, June 4). Massachusetts Medicaid and the Community Medical Alliance: A new approach to contracting and care delivery for Medicaid-eligible populations with AIDS American Journal of Managed Care, pp. 90—98.
  • Mitka, M. (1999). Enabling students to deal with the disabled. Journal of the American Medical Association, 281, 595—596.[CrossRef]
  • North Carolina Institute of Medicine. (2003 ). North Carolina Latino Health, 2003: Final report of the Latino Health Task Force Raleigh, NC: State Center for Health Statistics.
  • North End Outreach Network. (2003). North End strategic plan. Boston: Center for Reflective Community Practice, MIT.
  • Orc Macro. (2002). CalOptima 2001—2002 Blind and Disabled Adult Member Satisfaction Survey. Burlington, VT: Author.
  • Orlin, M. (1995). The Americans With Disabilities Act: Implications for social services. Social Work, 40, 233—239.[Medline] [Order article via Infotrieve]
  • Perez-Stable, E.J., Napoles-Spring, A., & Miramontes, J.M. (1997). The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Medical Care, 35, 1212—1219.[CrossRef][Medline] [Order article via Infotrieve]
  • Pierce, L.L. (1998). Barriers to access: Frustrations of people who use a wheelchair for full-time mobility. Rehabilitation Nursing, 23(3), 120—125.[Medline] [Order article via Infotrieve]
  • Schoenman, J.A. (1997). The impact of the Balanced Budget Act of 1997 on Medicare risk plan payment rates for rural areas Bethesda, MD: Project HOPE Center for Health Affairs.
  • Stafford, R.S., Davidson, S.M., Davidson, H., Miracle-McMahill, H., Crawford, S.L., & Blumenthal, D. (2003). Chronic disease medication use in managed care and indemnity insurance plans. Health Services Research, 38, 595—612.[CrossRef][Medline] [Order article via Infotrieve]
  • Steinberg, A.G., Sullivan, V.J., & Loew, R.C. (1998). Cultural and linguistic barriers to mental health service access: The deaf consumer's perspective. American Journal of Psychiatry, 155, 982—984.[Abstract/Free Full Text]
  • Use of clinical preventive services by adults aged 65 years enrolled in health-maintenance organizations—United States, 1996 (1998). Morbidity and Mortality Weekly Report, 47(16), 326—331.
  • Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. American Journal of Psychiatry, 158(12), 2027—2032.[Abstract/Free Full Text]
  • Witte, T.N., & Kuzel, A.J. (2000). Elderly deaf patients' health care experiences. Journal of the American Board of Family Practice, 13, 17—22.[Medline] [Order article via Infotrieve]

Journal of Disability Policy Studies, Vol. 18, No. 4, 197-204 (2008)
DOI: 10.1177/1044207307311304


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Bachman, S. S.
Right arrow Articles by Tierney, K.
Right arrow Search for Related Content
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?