Integrated Case Management: Does It Reduce Health Service Disparities Across African American and White Medicaid Beneficiaries?

Med Care Res Rev. 2017 Aug;74(4):486-501. doi: 10.1177/1077558716649879. Epub 2016 Jun 14.

Abstract

Evidence of persistent racial and ethnic disparities in health service use is substantial. Even among Medicaid beneficiaries, minority individuals may have lower use of specific health services relative to Whites due to varying degrees of trust in the health system, beliefs about the usefulness of medical treatment, provider stereotyping, or geographic service availability. Prior research demonstrated that a Florida Medicaid disease management program led to reductions in service disparities between Whites and African Americans. We study a Medicaid Integrated Case Management program implemented in Virginia, which shares disease management program objectives but can be applied to a broader range of patients. Two versions of the program are assessed, the latter of which incorporated more patient-focused and targeted approaches in identifying client needs and structuring patient interaction. Both versions of the program were associated with reductions in disparities, especially for physician services and when more targeted, patient-centered approaches were adopted.

Keywords: Integrated Case Management; Medicaid; health service disparities.

MeSH terms

  • Black or African American / statistics & numerical data*
  • Case Management / organization & administration*
  • Female
  • Health Services Accessibility*
  • Healthcare Disparities / ethnology*
  • Humans
  • Male
  • Medicaid
  • Middle Aged
  • Patient-Centered Care / methods
  • Racial Groups
  • United States
  • Virginia
  • White People / statistics & numerical data*