Dissertation/Thesis Abstract

Dual Eligibles' Experience of Care in North Carolina's Patient-Centered Medical Home
by Grantham, Sarah Catherine, Ph.D., The George Washington University, 2014, 283; 3617167
Abstract (Summary)

Individuals enrolled in both the Medicare and Medicaid programs, the "dually eligible," are generally vulnerable and face a wide range of health care needs; numerous studies have found that their health care is beset with problems of cost and quality. Health policy researchers find that these problems are directly associated with the inadequate coordination of benefits and services, but studies about care coordination have largely used quantitative approaches and focused on providers—they have not explored the critical perspective of patients receiving the care. To improve the complex processes of care coordination, this hybrid case study examines the experience of a sample of dual eligible enrollees served in North Carolina's patient centered medical home, and care managers. The subjects were generally independently living, and at lower-risk that typical dual eligibles. Although some experienced some continuity of care issues within NC's PCMH, generally they described receiving the right care, at the right time, in the right care settings. However, some experienced barriers to accessing necessary care, especially in the areas of prescription drugs and navigating the health care delivery system. Some of these challenges could potentially be resolved by NC's PCMH, but many issues are outside the program's control. Care managers who were interviewed suggested modifications to the Agency for Healthcare Research and Quality's Care Coordination Ring, which represents care coordination for a more stable, middle-class population than the dual eligibles they serve.

Indexing (document details)
Advisor: Infeld, Donna L.
Commitee: Goetz Goldberg, Debora, Lind, Alice, Lipson, Debra J., Mead, Katherine Holly, Rosenbaum, Sara
School: The George Washington University
Department: Public Policy and Public Administration
School Location: United States -- District of Columbia
Source: DAI-B 75/08(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Aging, Health care management
Keywords: Care coordination, Care manager, Dual eligibles, Fee for service, Patient centered medical home, Primary care
Publication Number: 3617167
ISBN: 9781303843112
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