Beyond the Water's Edge: Charting the Course of Managed Care for People with Disabilities - Conference Resource Book. Evaluation of the District of Columbia's Demonstration Program: Managed Care System for Disabled and Special Needs Children

11/01/1996

Carol Irvin, Ph.D.
As a Health Economist at Abt Associates, Inc., Carol Irvin has conducted numerous studies on the use, costs, and outcomes of health care services provided under managed care and fee-for-service arrangements. In current work she is analyzing enrollment patterns among applicants to the Program for All-Inclusive Care for the Elderly (PACE)--a capitated day health center program for frail elders. Dr. Irvin is also currently involved in analyzing the impacts of a new pharmaceutical product on the use and costs of health care services and labor market participation among individuals with chronic progressive multiple sclerosis. In earlier work funded by the Health Care Financing Administration, she has done comparisons of care and customer satisfaction of families in Florida, Michigan, and Maine enrolled in Medicaid managed care and fee-for-service providers. She has also analyzed the impact on health care use and economic outcomes of a national capitation demonstration project among mine workers--a high risk industry population.

Dr. Irvin has also been actively researching health care issues pertaining to the maternal and child populations. Research in this area include assessing Missouri's 1988 Medicaid expansion and its impacts on enrollment patterns of pregnant women and infants, prenatal care, birth outcomes, and infant health care. Related work includes on-going analysis of the Community Integrated Service Systems (CISS) serving women and children and a series of analyses of the Special Supplemental Food Program for Women, Infants, and Children (WIC) program.

THE DEMONSTRATION

  • Eligible Population
  • Plan Structure
  • Provider Network
  • Benefit Plan

ENROLLMENT

  • Enrollment Procedures
  • Challenges to the Enrollment Process
  • Current Enrollment Experience

COMPONENTS OF THE EVALUATION

  • Analyses of Enrollment
  • Implementation of the Demonstration
  • Outcome Analyses

DATA TO BE COLLECTED

  • Secondary Data Sources
  • MMIS
    • Plan encounter data
    • SSI eligibility data
  • Primary Data
    • Key informant interviews
    • Focus groups
    • Client survey
    • Medical record review

PRIMARY RESEARCH QUESTIONS

  • Analyses of Enrollment
    • Which children enroll?
    • Which children are long-term enrollees?
  • Implementation of the Demonstration
    • What can other states and managed care plans learn?
  • Outcomes Analyses
    • What are the experiences of the District, the managed care plan, the providers, and the children and their families under this type of health care system?

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