Designing Accessible Managed Care Services for People with Physical Disabilities: Consumer Suggestions Within an Emergent Design Process

Abstract

Persons with physical disabilities have difficulty accessing health care. This has become more pronounced with the emergence of managed care and other efforts to limit growing healthcare costs. In responding to a state's Medicaid office interest in designing accessible health services, a consumer-based evaluation including a series of nine focus groups (96 participants) was conducted using an emergent design method. Our inductive analysis approach identified difficulties and provided the basis for recommending strategies to improve access. Two sets of consumer recommended strategies consistently were expressed during this process: (1) initiating one-to-one advocacy to improve local service coordination and (2) performing person-centered planning at enrollment in a managed care plan to facilitate appropriate and prompt access. These access strategies formed the basis for a later intervention design.