Two counties in Florida were selected as pilots in 2006 for the Medicaid Demonstration Program. In reform counties, Medicaid enrollees were required to pick a managed care plan; either a Health Maintenance Organization or a Provider Service Network (PSN). PSNs are a form of managed care that provides health care services directly through a provider or network of organizations to a defined population without an intermediary. There are two types of PSNs: Physician-based PSNs and Healthcare system-based PSNs. The objective of this study is to find the differences in enrollees’ satisfaction between two different types of PSNs. To assess the differences in enrollees’ satisfaction between physician-based PSNs and health system-based PSNs over time, this study used difference-in-difference study design with CAHPS data from 2006 to 2008. The study findings showed that, compared to enrollees in physician-based PSNs, health system-based PSN enrollees had higher satisfaction during the post-reform period. However, the trends in satisfaction for enrollees in health system-based PSNs declined at a greater rate relative to the trends for enrollees in physician-based PSNs. Findings from this study may give other states, facing similar decisions to reform their Medicaid managed care system, information to decide whether to adopt a similar plan or to consider other interventions to improve Medicaid beneficiaries’ satisfaction. PSNs are structured similarly to the new accountable care organizations (ACO) models emerging as a result of the Affordable Care Act. Therefore, study findings may be helpful to in improving patient satisfaction with care in ACOs.

First Page


Last Page