Healthcare Decision-Making Among Dual-Eligible Immigrants: Implications from a Study of an Integrated Medicare-Medicaid Demonstration Program in California
| Autor: | Steven P. Wallace, Adrian Matias Bacong, Kaitlyn McBride, A. E. Benjamin, Ana Reynoso, Kathryn G. Kietzman |
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| Rok vydání: | 2019 |
| Předmět: |
Gerontology
Male medicine.medical_specialty Epidemiology media_common.quotation_subject Immigration Decision Making Vulnerability Eligibility Determination Emigrants and Immigrants Medicare California Interviews as Topic 03 medical and health sciences 0302 clinical medicine Health care medicine Humans 030212 general & internal medicine Qualitative Research media_common Aged 030505 public health business.industry Medicaid Public health Patient Protection and Affordable Care Act Managed Care Programs Public Health Environmental and Occupational Health Middle Aged United States Integrated care Managed care Female Health care reform 0305 other medical science business Psychology |
| Zdroj: | Journal of immigrant and minority health. 22(3) |
| ISSN: | 1557-1920 |
| Popis: | To improve the coordination of long-term services and supports for dual-eligibles (those with both Medicare and Medicaid), California created Cal MediConnect (CMC), an Affordable Care Act-authorized managed care demonstration program. Beneficiaries were “passively enrolled” into CMC, meaning they were automatically enrolled unless they actively opted out. The aim of this study was to examine differences in factors influencing the enrollment decisions of U.S. born and immigrant dual-eligible beneficiaries. To explore differences in decision-making processes, we conducted in-depth interviews with dual-eligible consumers (39 native and 14 immigrant) in Los Angeles County. Interviews were analyzed using a constructivist grounded theory approach. Our findings illustrate a heightened sense of vulnerability and disempowerment experienced by immigrant participants. Immigrant participants also faced greater challenges in accessing healthcare and eliciting healthcare information compared to U.S.-born participants. Understanding the diverse perspectives of dual-eligible immigrant healthcare decision-making has implications for health care reform strategies aimed at ameliorating disparities for vulnerable immigrant populations. |
| Databáze: | OpenAIRE |
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