Informed participation in TennCare by people with disabilities

Informed consumer participation in health care is increasingly important, but people with disabilities face barriers to making health care decisions. Using a unique survey, we examine informed health care choices by nonelderly people with diverse disabilities, including mental retardation, mental illness, visual and hearing impairments, and difficulty communicating, in TennCare, Tennessee's Medicaid managed care program. Most people with disabilities chose their plans and providers, felt they had enough information to choose a plan, and rated information from their providers as good to excellent. A minority did not know they could choose their plans and providers and reported poor or fair communication with providers. Adults with mental retardation were less likely than other adults with disabilities to seek information. Adults with serious difficulty communicating were less satisfied than others with information from providers. Medicare, Medicaid, health plans, and providers should tailor information dissemination to the diverse needs of people with disabilities.