Do medical homes offer improved diabetes care for Medicaid enrollees with co-occurring schizophrenia?
Purpose. To determine whether Medicaid recipients with co-occurring diabetes and schizophrenia that are medical-home-enrolled are more likely to receive guideline concordant diabetes care than those who are not medical-home-enrolled, controlling for confounders. Methods. We used administrative data on adult, non-dually eligible North Carolina Medicaid beneficiaries with diagnoses of both diabetes and schizophrenia (N=3,897) for fiscal years 2008-2010. We evaluated the relationship between medical-home enrollment and receipt of recommended diabetes care reimbursed by Medicaid (lipid profiles, HbAlc tests, medical attention for nephropathy, and eye exams for those over 30), using fixed-effects regression models on person-month level data. Results. There was a statistically significant, positive effect of medical home enrollment on receipt of Medicaid-funded eye exams, HbAlc tests, and medical attention for nephropathy, but not receipt of lipid profiles. Conclusions. For Medicaid enrollees with diabetes and schizophrenia, medical home enrollment is generally associated with greater likelihood of receiving guideline concordant diabetes care.