How Does Managed Care Affect Workers Who are Chronically Ill or Disabled?

From 1996 to 1998, researchers from the Yale University School of Medicine examined how working people with chronic illnesses and functional limitations fare under various forms of prepaid managed health care plans.

Researchers analyzed data from the 1993 Employee Health Care Value Survey, a national survey of more than 20,000 employees of three national corporations, which measured employees' satisfaction with their health-care plans.

Key Findings

  • Individuals suffering from physical or depressive symptoms were more likely to be enrolled in fee-for-service than managed care plans.

  • Individuals with chronic illnesses who were enrolled in managed care plans were more likely to be dissatisfied with their care than those without chronic illnesses.

  • Opportunities for switching plans appeared to be significantly limited for enrollees with serious health problems.

  • People with high levels of depressive symptoms appeared to be less willing or able than other individuals to act on their dissatisfaction by switching plans.

  • Minority enrollees in managed care plans were significantly more likely to be dissatisfied with their treatment than were comparable white enrollees in the same plans.