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Managed Care & Persons with Disabilities & Chronic Illnesses
Defining the Populations
Mary F. Harahan, Acting Deputy Assistant Secretary, Office of Disability, Aging and Long-term Care Policy,
Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services (HHS),
This first substantive session established a valuable platform for subsequent sessions by first placing the issue of enrolling
persons with disabilities or chronic illness in managed care arrangements in a broader policy context. The presenter, Mary Harahan, Acting Deputy Assistant Secretary of the HHS Office of Disability,
clarified that chronic illness and disability are not identical: disability results from a chronic or acute illness, injury, or
impairment but not all people with chronic illness are disabled.
Ms. Harahan then shared with participants soon-to-be-published information from the 1994 Disability Survey that
provided important information about the size and characteristics of the population of persons with disabilities in the
Among the findings reported from the survey were the following:
- The number of persons with disabilities ranged considerably, from 13.7 million to 59.4 million, depending upon the
definition of disability used.
- The population of persons with disabilities is very heterogeneous.
- Disability rates across States differ significantly.
- Significant portions of children and working age adults with disabilities are uninsured (13.1 percent and 18 percent,
- With respect to Medicaid, functional disability rates are high among Aid to Families with Dependent Children (AFDC) adults and children.
- Significant differences in health care utilization are found within Medicaid recipients in different age groups on the
basis of disability.
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and
Evaluation. Overview of Disability and Long-term Care Needs Among the U.S. Population. ASPE Research Notes,
Special Edition (forthcoming).
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of
Disability, Aging, and Long-term Care Policy 1992-1996. Disability, Aging, and Long-term Care Policy Research.
Washington, DC. U.S. Government Printing Office, 1997.
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