title: Effects of an Integrated Care System on quality of care and satisfaction for children with special health care needs.
abstract: To assess the effects of an Integrated Care System (ICS) on parent-reported quality of care and satisfaction for Children with Special Health Care Needs (CSHCN). In 2006 Florida reformed its Medicaid program in Broward and Duval counties. Children's Medical Services Network (CMSN) chose to participate in the reform and developed an ICS for CSHCN. The ICS ushered in several changes such as more prior approval requirements and closing of the provider network. Telephone surveys were conducted with CMSN parents whose children reside in the reform counties and parents whose children reside outside of the reform counties in 2006 and 2007 (n = 1,727). Results from multivariate quasi-experimental models show that one component of parent-report quality of care, customer service, increased. Following implementation of the ICS, customer service increased by 0.22 points. After implementation of the ICS, parent-reported quality and satisfaction were generally unaffected. Although significant increases were not seen in the majority of the quality and satisfaction domains, it is nonetheless encouraging that parents did not report negative experiences with the ICS. It is important to present these interim findings so that progress can be monitored and decision-makers can begin to consider if the program should be expanded statewide.
authors.affiliation: Department of Health Outcomes & Policy, University of Florida, 1329 SW 16th Street, Room 5130, Gainesville, FL 32610, USA. cak@ichp.ufl.edu
authors.forename: Caprice
authors.initials: C
authors.lastname: Knapp
authors.forename: Vanessa
authors.initials: V
authors.lastname: Madden
authors.forename: Phyllis
authors.initials: P
authors.lastname: Sloyer
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shenkman
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid; D020380:Needs Assessment; D010290:Parents / Q000523:psychology*; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult