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Disparities/Minority Health

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Information about health plans should be tailored to meet the diverse needs of people with disabilities

Individuals with disabilities, who typically have complex medical needs, often need more information to choose a health plan than people without disabilities. However, they often have a harder time getting the information they need. Getting health plan information to people with disabilities requires multiple methods, such as written materials, audiotapes, videos, hotlines, one-on-one outreach counselors, and the Internet.

Steven C. Hill, Ph.D., of the Agency for Healthcare Research and Quality, and Judith Wooldridge, M.A., of Mathematica Policy Research, Inc., surveyed individuals with disabilities enrolled in Tennessee's Medicaid managed care program (TennCare) in 1998 and 1999 about whether they felt they had enough information to choose a health plan.

Some adults had limitations that could affect their ability to obtain information about health plans. For example, 14 percent received help using the telephone; 8 percent had serious difficulty communicating with someone outside the family; 1 percent were hearing impaired; and 2 percent were visually impaired. Also, 15 percent had trouble getting around inside the home, and thus would probably need help traveling to workshops and health fairs to get information. Thirty-three percent of adults had mental retardation, 31 percent had mental illness, and 24 percent had physical disabilities.

Most individuals with disabilities chose their managed care plan and providers, felt they had enough information to choose a plan, and rated information from their providers as good to excellent. However, a minority did not know they could choose their plans or providers and reported poor or fair communication with providers.

Adults with mental retardation were less likely than other adults with disabilities to seek information. Adults with serious difficulty communicating were less satisfied than others with information from providers. Information from nearly every source (health plans, the State, friends, and relatives) was associated with choosing plans.

See "Informed participation in TennCare by people with disabilities," by Dr. Hill and Ms. Wooldridge, in the November 2006 Journal of Health Care for the Poor and Underserved 17, pp. 851-875.

Reprints (AHRQ Publication No. 07-R045) are available from the AHRQ Publications Clearinghouse.

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