title: Fee-for-service and managed care for seniors and people with disabilities on Medicaid: implications for the managed care mandate in California.
abstract: OBJECTIVE
  To assess differences in perceived quality of care between fee-for-service (FFS) and managed care Medicaid (MMC) by seniors and persons with disabilities (SPD) and to generate hypotheses for future evaluations of the new managed care mandate for SPD in California.
  
  
  METHODS
  A cross-sectional telephone survey of 403 SPD Medicaid beneficiaries comparing perceived access to, satisfaction with, and quality of care between beneficiaries who had voluntarily enrolled in MMC with those who had remained in FFS.
  
  
  RESULTS
  Beneficiaries in MMC were more likely to be "very satisfied" with their benefits than those in FFS. There was no significant difference on any measure of access to care. Most beneficiaries in MMC reported their access to and quality of health care was either the same or better than it had been in FFS.
  
  
  CONCLUSIONS
  On most measures, MMC was rated either the same or better than FFS by SPD beneficiaries who voluntarily enrolled in MMC.
authors.affiliation: Health Research for Action, School of Public Health, University of California—Berkeley, Berkeley, CA 94704, USA. clgraham@berkeley.edu
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Graham
authors.forename: Elaine
authors.initials: E
authors.lastname: Kurtovich
authors.forename: Susan L
authors.initials: SL
authors.lastname: Ivey
authors.forename: Linda
authors.initials: L
authors.lastname: Neuhauser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D018588:Fee-for-Service Plans / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D017060:Patient Satisfaction; D011787:Quality of Health Care; D020377:Self Efficacy; D014481:United States