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- Title
Healthcare Decision-Making Among Dual-Eligible Immigrants: Implications from a Study of an Integrated Medicare-Medicaid Demonstration Program in California.
- Authors
McBride, Kaitlyn; Bacong, Adrian M.; Reynoso, Ana; Benjamin, A. E.; Wallace, Steven P.; Kietzman, Kathryn G.
- Abstract
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.
- Subjects
UNITED States; CALIFORNIA; BLACK people; GROUNDED theory; HEALTH services accessibility; HEALTH status indicators; HISPANIC Americans; PSYCHOLOGY of immigrants; INTERVIEWING; LONG-term health care; MEDICAID; MEDICAL care; EVALUATION of medical care; MEDICARE; QUALITY assurance; SELF-efficacy; SOCIAL networks; WHITE people; SOCIAL support; EDUCATIONAL attainment; HUMAN services programs; INDEPENDENT living; PATIENT Protection &; Affordable Care Act; PATIENT decision making
- Publication
Journal of Immigrant & Minority Health, 2020, Vol 22, Issue 3, p494
- ISSN
1557-1912
- Publication type
Article
- DOI
10.1007/s10903-019-00922-5