Managed Care and Value-Based Payment: The Relationship Between Quality of Life Outcomes and Emergency Room Utilization

Intellect Dev Disabil. 2021 Feb 1;59(1):22-38. doi: 10.1352/1934-9556-59.1.22.

Abstract

Although Medicaid managed care is a growing service model, there is a limited evidence base regarding quality and value-based payment standards for people with intellectual and developmental disabilities (IDD). This study examined the relationship between emergency room utilization and quality of life outcomes. We analyzed secondary Personal Outcome Measures quality of life and emergency room utilization data from 251 people with IDD. According to our findings, people with IDD with continuity and security in their lives and/or who participated in the life of the community had fewer emergency room visits, regardless of their impairment severity or dual diagnosis status. As such, the number of emergency room visits needed, and the potential expenditures associated, may be reduced by focusing on quality outcomes.

Keywords: Medicaid managed care; emergency room utilization; long-term services and supports; quality of life.

MeSH terms

  • Child
  • Developmental Disabilities
  • Emergency Service, Hospital
  • Humans
  • Intellectual Disability*
  • Managed Care Programs
  • Medicaid
  • Quality of Life*
  • United States