Family reports of care denials for children enrolled in TennCare

Pediatrics
Robert S ValetWilliam O Cooper

Abstract

Twenty-three million people, accounting for >58% of Medicaid enrollees, are enrolled in Medicaid managed care programs. Although the expectation of management in Medicaid managed care programs necessitates restrictions in use of some services sought by patients and families, the circumstances surrounding care denial and related access problems in vulnerable populations of children have not been studied. The objective of this study was to identify experiences with care denial reported by families in TennCare, Tennessee's managed care program for Medicaid enrollees and uninsured. Primary caregivers for 399 children who were enrolled in TennCare and presented for care at 21 pediatric and family medicine sites throughout Tennessee participated in a face-to-face interview. Of the 399 caregivers who participated in the study, 146 (36.6%) reported that their child experienced denial of care in the previous 12 months at a physician's office (12.5% of those interviewed), dentist's office (13.8%), or pharmacy (20.0%). For denial of any 1 type of care, families of children with chronic conditions (multivariable odds ratio [OR]: 2.05; 95% confidence interval [CI]: 1.41-2.99) and those whose parents had >12 years of education (OR: 1.80; CI:...Continue Reading

References

Sep 2, 2000·Pediatrics·M E MansourT G DeWitt
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Mar 13, 2002·Ambulatory Pediatrics : the Official Journal of the Ambulatory Pediatric Association·Christina D BethellPaul W Newacheck

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Citations

Mar 19, 2013·Research in Developmental Disabilities·Vijaya KancherlaMarshalyn Yeargin-Allsopp
Nov 12, 2005·Current Opinion in Pediatrics·Patrick M Vivier
Nov 12, 2005·Current Opinion in Pediatrics·Yvonne W Fry-JohnsonGeorge Rust
Jul 20, 2005·Pediatric Emergency Care·Sarah Grim HostetlerGary A Smith
Aug 28, 2012·Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners·Jennifer E DevoeHeather Angier
Apr 4, 2008·Health Services Research·Howard WaitzkinCathleen E Willging
Sep 10, 2014·Administration and Policy in Mental Health·Sigrid JamesSusanne B Montgomery
Dec 20, 2013·Maternal and Child Health Journal·Amanda Haboush-DeloyeDenise Tanata-Ashby
Oct 7, 2020·Hospital Pediatrics·Rosanna FulchieroCourtney Port

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