Managed Care Creates Barriers For Low-Income Women
Medicaid managed care health plans neglect the needs of low-income women, especially those with chronic illnesses such as HIV/AIDS, according to a new study by the Center for Women's Policy Studies, released last week.
The report, "Managed Care: Serving the Needs of Women," primarily finds fault with the coordination of care provided by Medicaid managed care plans.
These plans increase the fragmentation of low-income women's healthcare by requiring that enrollees go outside their plan for several Medicaid-covered services, such as family planning, substance abuse care and STD/HIV treatment.
Managed care systems provide healthcare services to about 25% of people in the federal Medicaid program More than 75% of women with HIV/AIDS have public insurance, primarily Medicaid.
Based on the Center's review of Medicaid managed care plan contracts in 10 states and the District of Columbia, it identifies three major communication-oriented weaknesses that include:
- Failing to provide a comprehensive package of Medicaid-covered health services like formal referrals for services outside the plan;
- Failing to offer consumer accountability systems such as impartial advocates to help enrollees pursue grievances and appeals of coverage decisions; and
- Failing to guarantee open provider-patient communications and protect the confidentiality of medical records.
The report also includes more than 100 consumer protections and safeguards recommended for Medicaid managed care plans. (Center for Women Policy Studies, 202/872-1770)
Consumers Open to Ads of Embarrassing Medical Problems
Consumers are not discomfited by ads that promote drugs for difficult-to-discuss medical conditions like STDs, says a new study by New York-based Health Medical Consumer Advertising & Marketing.
The study surveyed 1,000 consumers nationwide on their reactions to the FDA's recent rulings relating to broadcast advertising for prescription medications.
Medical issues that were deemed acceptable for advertising include:
- STDs/venereal diseases (66%);
- contraception (64%);
- weight loss (62%);
- depression (59%); and
- enlarged prostate (56%).
The study is part of HMC Mindset, an ongoing research project conducted to keep industry clients abreast of changing healthcare trends. (HMC, Mary Churchill, 212/370-2525)
Gender Impacts Communication Between Doctors, Patients
Male doctors must communicate more effectively with female patients, according to a new study released last week by the Mayo Clinic.
The study, which evaluated how often patients and their doctors agree on reasons for office visits, found that male doctors tended to be unaware of their female patients' primary purpose for routine medical examinations.
Patients and doctors were asked to rank, in descending order of importance, the factors they believed motivated the visit.
Routine physicals, cancer screenings, hypertension, cholesterol counts and heart conditions topped the list. Based on responses from 458 patients and 57 doctors, the study found that:
- The likelihood that male doctors and patients disagree on the reason for office visits more than doubles when the patient is female;
- Multiple reasons for an office visit contributed to the breakdown in doctor-patient communication; and
- Reason-for-visit miscommunications did not seem to influence a patient's overall satisfaction with the quality of care provided.
Researchers speculate that other factors, such as the doctor's interpersonal skills and professionalism, play more significant roles in shaping patient perceptions of physicians. (Mayo Clinic, 507/284-2511)