Transcript Plan Evaluation by Consumers with Mobility Impairments

Enhancing Consumer Choice
of Health Plans for People
with Disabilities
Sue Palsbo, PhD
May, 2001
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
Informed Choice Domains
Accreditation of Disability Literacy
Structure & Processes
Outcomes
Surveys &
Utilization Measures
Excellence
Physician
Credentialling
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
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?
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
Covered Benefits
• “Medical necessity”
• Interest in specific benefits varied by
impairment origin
• Benefits administration
– Rx formularies
– DME
– transportation
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
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
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
Access
• Direct access to experienced physicians
(specialists)
• Transportation
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
Navigating the Health Plan
• More information about grievance and
appeals process
• Materials available in accessible
formats for people with visual and
hearing impairments
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
CAHPS®
• Content analysis
• Some items fully addressed; others
partially or not addressed
• Collaborating with AHRQ to develop a
“CAHPS for People with Mobility
Impairments”
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
®
HEDIS
• Preventive care measures very relevant
because of documented disparity in
delivered care
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research
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
RRTC
Managed Care
& Disability
NRH Center for Health
and Disability Research