The evaluation of fee for service and managed care from the viewpoint of people with disabilities in the USA

In the literature on managed health care there is little presented from the viewpoint of people with disabilities, but this study looks at what is found. Using a sample of 258 disabilities in Massachusetts obtained through a mail survey, no statistically significant differences between the two groups (fee for service or managed care) on a series of relevant variables was found. An evaluation of their health insurance and their primary care physician was asked for and several regression models of the relevant variables related to these two evaluations were tested. It seems that accessibility of the primary care physicians's office and the physician's level of understanding of the person's disability are related in a statistically significant way to their rating of their health insurance. Also it appears that the ease of obtaining an appointment and the physician's level of understanding of the person's disability are related in a statistically significant way to the evaluation of their primary care physician. The major policy implication of these findings is that managed care may not be the disaster which many foresee it to be.