Medicaid Beneficiaries Respond Differently Than Privately Insured Individuals to Disease Management Programs, Study Finds

Main Category: Medicare / Medicaid / SCHIP
Article Date: 30 Mar 2005 - 11:00 PDT

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Low-income Medicaid beneficiaries and privately insured individuals do not respond in the same ways to disease management programs, and organizers should gear programs to address the unique needs of each population, according to a study released Tuesday by the... Health Strategies Consultancy and Duke University, NPR's "Morning Edition" reports (Rovner, "Morning Edition," NPR, 3/29). For the study, funded through an educational grant from Pfizer Health Solutions, researchers interviewed 27 stakeholders in Florida's Medicaid disease management program, including care managers, program administrators, medical directors, state officials, disease groups and community organizations (Health Strategies release, 3/29). Under a contract announced in 2001, Pfizer agreed to establish care guidelines, pay case workers to monitor Florida Medicaid beneficiaries and communicate with physicians to help reduce the length of hospital stays. The contract exempted Pfizer from a 2001 state law that requires pharmaceutical companies to provide discounts on prescription drugs in addition to the rebate required under federal Medicaid law to have their products appear on state Medicaid prescription drug formulary (Kaiser Daily Health Policy Report, 11/11/04). The researchers found that Medicaid beneficiaries, in comparison with privately insured individuals, tend to have increased mobility, lower literacy, more language barriers, poorer health and less trust of "outsiders" (Health Strategies release, 3/29). According to lead study author Chiquita White, one successful strategy for counteracting low-income beneficiaries' suspicions of health care providers was for care managers to resolve nonhealth-related issues, such as food or housing assistance, before addressing health behaviors ("Morning Edition," NPR, 3/29).

The complete segment is available online in RealPlayer.

The study is available online.

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