Using MSIS Data to Analyze Medicaid Eligibility and Managed Care Enrollment Patterns in 1999. Tables 10A-10F: Managed Care Enrollment for Disabled Persons and Children in Foster Care by Age Cohort, Gender and Plan Type in December 1999

02/01/2003

Table 10A shows managed care enrollment patterns for two groups of special interest to policymakers: disabled persons and children in foster care. For both groups, results are presented by age. For disabled persons, results are also stratified by eligibility group. Tables 10B and 10C present the same information for females and males, respectively. These special compilations of data on disabled and foster care enrollees were requested by OASPE staff. The counts in these three tables are duplicated, since an individual could have been enrolled in more than one type of managed care plan in December 1999, in which case he or she would have been counted more than once. Tables 10D-F convert the data in Tables 10A-C to a percent distribution; percentages reflect the duplicated counts in Tables 10A-C.

Three age groups are used for disabled persons: under age 21, age 21-64, and age 65 and older. Unlike other Medicaid eligibility groups, disabled persons can be any age. Children can qualify as disabled if they have medically determinable physical or mental impairment which result in marked and severe functional limitations that are expected to last for a continuous period of not less than 12 months, or to result in death.2 Low-income working age adults are considered disabled if they are unable to engage in substantial gainful activity by reason of any medically determinable mental or physical impairment which can be expected to result in death or can be expected to last for a continuous period of not less than 12 months. Finally, some (but not all) states report persons age 65 and over as disabled. Generally, disabled persons who are age 65 or over in Medicaid data are persons who initially qualified for Medicaid as disabled who continue to be reported in the disabled eligibility group when they turn age 65. Six age groups are used for foster care children: less than 1 year, 1 to 4 years, 5 to 9 years, 10 to 14 years, 15 to 18 years and over age 18.

Findings

  • As reported earlier, in December 1999, just over half (57 percent) of the disabled enrolled in Medicaid were not enrolled in any type of managed care plan (Table 10D). The pattern is similar for foster care children -- about 58 percent were not enrolled in any type of managed care plan.

  • Three-quarters of the disabled persons enrolled in Medicaid in December 1999 qualified through the SSI eligibility group. Disabled persons in the SSI group were more likely to be participating in a managed care plan than disabled persons in the medically needy, poverty-related and other eligibility groups. Within the SSI group, children were more likely than disabled persons in the other two age groups to be participating in a managed care plan. About 55 percent of children under age 21 in the SSI group were participating in some type of managed care, compared to 49 percent of SSI disabled persons aged 21 to 64, and 45 percent age 65 or older (Table 10D).

  • Foster care children did not show major differences in managed care participation by age (Table 10D).

  • Managed care enrollment patterns did not differ by gender for disabled beneficiaries and foster care children (Tables 10E and 10F).

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