Title

A study of the relationship between health care access and access barriers to behavioral health care for African Americans utilizing the managed care model

Date of Award

January 2001

Degree Type

Dissertation

Degree Name

Ph.D.

Abstract

Managed care has revolutionized the healthcare industry. Prior to managed care, traditional insurance companies managed the healthcare industry. These insurance firms would monitor and authorize treatment to persons enrolled with the insurance company. Health Maintenance Organizations (HMOs) began to develop methods to provide similar service as the large insurance companies at a fraction of the cost. HMOs accomplished this by selling their products directly to employer groups. This significantly reduced administrative costs that had been traditionally passed on to the consumer. Unable to financially keep pace with the HMOs, the insurance companies abandoned the health insurance arena. As managed care has grown so have the problems associated with his system. Issues involving antitrust, confidentiality, privacy, and best practices are but a few of the critical issues facing managed care. All three branches of the United States government have been involved in resolving issues pertaining to managed care. Reforms have been demanded from the system and the current political climate may force the system to reconsider the manner in which it is conducting business. Minority consumers and specifically African Americans traditionally have been discriminated against from engaging in such life activities as housing, voting, commerce, and banking, without judicial intervention. The healthcare industry is no exception. The United States Surgeon General, in his seminal report on mental health, identifies that African Americans and other minorities have been excluded from obtaining appropriate and timely healthcare. The Surgeon General's report coupled with the President's report on Healthy People 2000, identify that initiatives are needed to rectify the inequities in healthcare in healthcare service delivery. A total of fifty-two African American consumers of mental health service with a primary diagnosis of adjustment disorder were surveyed to assess their perceptions as to whether or not they have access to their behavioral health services. The Consumer Access Questionnaire was designed to gather both demographic and consumer perceptions on the accessibility and feasibility of managed care for this selected population of African Americans. In all categories surveyed on the questionnaire, the results revealed that the respondents were able to access their outpatient behavioral health provider when utilizing the managed care system. The respondents provided an overall satisfaction rate with their respective managed care plans.