Managed Health Care, Elderly Access and Satisfaction

Saint Louis University, Saint Louis MO

Investigators

Abstract

Recently implemented major changes in the Medicare program, especially the introduction and projected expansion of Medicare-Choice (M+C) plans or the Part C option, potentially have significant implications for older health care consumers. This pilot study grant application addresses the topic of "how the organization and delivery of care for older people influence health-related behaviors and outcomes" contained within topic #23 (Care for Older People) in the NIA Pilot Research Grant Program description dated February 2,2000. The goals of this proposed pilot study are to: explore alternative methods that can be used to describe the basic of managed care arrangements that arise within a local market, examine approaches that are used to describe and assess developmental stages of managed care organization (MCOs) within local market; understand the major issues that BBA 97 will likely pose to Medicare beneficiaries; and to develop a suitable conceptual framework and appropriate research instruments to gain a better understanding of the micro-level impacts of BBA 97 on elderly clients. The five specific aims and methods of the project are to: (1) Conduct a comprehensive literature review focused on published and unpublished reports of attempts to characterize the major elements of managed care arrangements, changing types of MCOs and how the development of local markets can best be understood over time; (2) Perform focus groups comprised of older persons in the community in order to understand better the current levels of client understanding of the types of health plan choices that will be required of Medicare beneficiaries and the potential impacts of consumer choices; (3) Examine conceptual frameworks that are used to understand the dynamics of doctor-elderly client interaction and the effects of such patterns of activity upon client service access and satisfaction; (4) Assess current methodological approaches and instruments that can be used to understand the dynamics and outcomes of doctor-elderly client interaction and to prepare new measures as needed; and (5) Draft a report that will summarize the study's findings of the literature review, results of the consumer focus groups and approaches to understanding the dynamics and outcomes of doctor-older client interaction amidst a rapidly changing health care environment.