title: Medicaid managed care: issues for beneficiaries with disabilities.
abstract: BACKGROUND
  States are increasingly turning to managed care arrangements to control costs in their Medicaid programs. Historically, such arrangements have excluded people with disabilities who use long-term services and supports (LTSS) due to their complex needs. Now, however, some states are also moving this population to managed care. Little is known about the experiences of people with disabilities during and after this transition.
  
  
  OBJECTIVE
  To document experiences of Medicaid enrollees with disabilities using long-term services and supports during transition to Medicaid managed care in Kansas.
  
  
  METHODS
  During the spring of 2013, 105 Kansans with disabilities using Medicaid long-term services and supports (LTSS) were surveyed via telephone or in-person as they transitioned to managed care. Qualitative data analysis of survey responses was conducted to learn more about the issues encountered by people with disabilities under Medicaid managed care.
  
  
  RESULTS
  Respondents encountered numerous disability-related difficulties, particularly with transportation, durable medical equipment, care coordination, communication, increased out of pocket costs, and access to care.
  
  
  CONCLUSIONS
  As more states move people with disabilities to Medicaid managed care, it is critically important to address these identified issues for a population that often experiences substantial health disparities and a smaller margin of health. It is hoped that the early experiences reported here can inform policy-makers in other states as they contemplate and design similar programs.
authors.affiliation: Institute for Health and Disability Policy Studies, University of Kansas, 1122 West Campus Rd., Room 517, Lawrence, KS 66045, USA; Department of Health Policy and Management, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 3044, 5001 Student Center, Kansas City, KS 66160, USA. Electronic address: jhall@ku.edu.
authors.forename: Jean P
authors.initials: JP
authors.lastname: Hall
authors.affiliation: Institute for Health and Disability Policy Studies, University of Kansas, 1122 West Campus Rd., Room 517, Lawrence, KS 66045, USA.
authors.forename: Noelle K
authors.initials: NK
authors.lastname: Kurth
authors.affiliation: Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Box 3903, Durham, NC 27710, USA.
authors.forename: Shawna L C
authors.initials: SL
authors.lastname: Chapman
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas Medical Center, 3901 Rainbow Blvd, Mailstop 1008, 4030 Robinson, Kansas City, KS 66160, USA.
authors.forename: Theresa I
authors.initials: TI
authors.lastname: Shireman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000592:standards*; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007615:Kansas; D008134:Long-Term Care / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008484:Medicaid; D008875:Middle Aged; D014481:United States
keywords: Disabilities; Long-term services and supports (LTSS); Managed care; Medicaid