SSI Beneficiaries' Experience in the Oregon Health Plan Part 2: A Comparison of Dual Eligible and Non-Dual Adults Age 19-64 in Medicaid Managed Care
Based on analyses of a beneficiary survey and case study findings, this paper describes a subset of the SSI population in Oregon, and the experience of these beneficiaries with the Oregon Health Plan. One of a series of reports on the Oregon Health Plan (OHP) resulting from the HCFA and ASPE funded evaluation of this section 1115 Medicaid waiver, this report focuses on community-residing SSI beneficiaries age 19-64 in Medicaid managed care, including both Medicare/Medicaid dual eligibles and those with only Medicaid coverage (non-dual eligible). Several aspects of the beneficiary survey provide a rich opportunity for analysis: (1) use of Medicare data to distinguish dual eligibles who are also in Medicare managed care plans from those in Medicare fee-for- service; (2) use of Social Security Administration data providing reason for SSI eligibility allowing cross disability group comparisons; and (3) detailed functional status measures that permit additional case mix measures. Companion papers report on the experience of children with special health care needs (with and without SSI), compare non-dual working age adults in managed care to those exempted from managed care under OHP, and report on the beneficiary experience with mental health services.