Do medical homes offer improved diabetes care for medicaid enrollees with co-occurring schizophrenia?

William J. Olesiuk, Joel F. Farley, Marisa Elena Domino, Alan R. Ellis, Joseph P. Morrissey, Jesse C. Lichstein, Christopher A. Beadles, Carlos T. Jackson, C. Annette DuBard

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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, HbA1c 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, HbA1c 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.

Original languageEnglish (US)
Pages (from-to)1030-1041
Number of pages12
JournalJournal of health care for the poor and underserved
Volume28
Issue number3
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
This study has been presented at the AcademyHealth Annual Research Meeting on June 16, 2015 in Minneapolis, MN. Funding for this study was provided by AHRQ: R24 HS019659-01. Dr. Farley was additionally supported by Agency for Healthcare Research and Quality (RO1 HS023099). Additional funding for Dr. Olesiuk was provided by Grant No. 5T32MH019117-25 from the National Institute of Mental Health. Additional funding for Dr. Beadles was provided by Grant No. 5T32-HS000032 from the Agency for Healthcare Research and Quality and Grant No. TPP 21-023 from the Department of Veteran Affairs Office of Academic Affiliations. Additional funding for Dr. Lichstein was provided by 2T32NR008856 from the National Institute of Nursing Research.

Publisher Copyright:
© Meharry Medical College.

Keywords

  • Chronic disease
  • Diabetes
  • Patient-centered care
  • Schizophrenia

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