Parents' Perspectives of Managed Care: Implications for Pediatric Physical Therapy

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Increasingly, parents are enrolling their children with special health care needs (5HCN) in private and public sector managed care health plans. Although these plans have the potential to provide comprehensive and coordinated health services, it is not yet known if managed care arrangements will meet the special needs of this population.

A pilot survey of 33 parents was conducted to examine the parents' perceptions of their children's health care plans. The parents who participated in this survey were state coordinators for Family Voices, a national advocacy organization for families of children with SHCN. This study investigated the impact of managed care and fee-for-service plans on access to health services and compared parent satisfaction with managed care to satisfaction with fee-for-service plans. Specific health services pertinent to pediatric physical therapy were identified for these comparisons.

Parents reported overall satisfaction with services available in their children's health plans in most areas surveyed. However, only 29.6% of the parents surveyed were satisfied with their access to a care coordinator and only 46.7% were satisfied with the level of coordination among health professionals. Parents whose children were in fee-for-service health plans reported more satisfaction than those in managed care plans in the majority of areas surveyed. We discuss implications for pediatric physical therapists working in managed care plans concerning communication with administrators of these plans, documentation of therapy sessions, and implementation of family-centered care.

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