NRH Center for Health and Disability Research RRTC Managed Care & Disability Enhancing Consumer Choice of Health Plans for People with Disabilities Sue Palsbo, PhD May, 2001

NRH Center for Health and Disability Research RRTC Managed Care & Disability Informed Choice Domains Accreditation of Disability Literacy Surveys & Utilization Measures Physician Credentialling ExcellenceOutcomes Structure & Processes

NRH Center for Health and Disability Research RRTC Managed Care & Disability Questions How do people with mobility impairments select a health plan and measure quality? What are their priorities? What information do they need? Do existing “Report Cards” provide that information?

NRH Center for Health and Disability Research RRTC Managed Care & Disability Covered Benefits “Medical necessity” Interest in specific benefits varied by impairment origin Benefits administration –Rx formularies –DME –transportation

NRH Center for Health and Disability Research RRTC Managed Care & Disability Providers Will I be under the care of a physician with specialized knowledge about my condition? Is my primary care physician building accessible? Physician sensitivity to disability

NRH Center for Health and Disability Research RRTC Managed Care & Disability Access Direct access to experienced physicians (specialists) Transportation

NRH Center for Health and Disability Research RRTC Managed Care & Disability Navigating the Health Plan More information about grievance and appeals process Materials available in accessible formats for people with visual and hearing impairments

NRH Center for Health and Disability Research RRTC Managed Care & Disability CAHPS ® Content analysis Some items fully addressed; others partially or not addressed Collaborating with AHRQ to develop a “CAHPS for People with Mobility Impairments”

NRH Center for Health and Disability Research RRTC Managed Care & Disability HEDIS ® Preventive care measures very relevant because of documented disparity in delivered care

NRH Center for Health and Disability Research RRTC Managed Care & Disability Accreditation Suggested criteria: –under the control of the health plan –objective and can be audited –little or no cost to health plans to implement –necessary for high quality –can be consolidated into a single rating