What Do Medicaid Members Want From Their Health Plan? Insights From a Qualitative Study to Improve Engagement in Case Management.

PURPOSE OF STUDY: Managed care organizations (MCOs) provide case management services to address unmet health and social needs among their members. Few studies have examined factors influencing members' decision to participate in these programs. The purpose of the present study was to describe the life circumstances of Medicaid members offered case management, what they wanted from their MCO, and their perceptions of case management and barriers to participation. Results will inform practice to raise the awareness, engagement, and impact of case management programs. PRIMARY PRACTICE SETTINGS: Case management offered through a Midwestern Medicaid MCO. METHODOLOGY AND SAMPLE: Adult members who had been offered case management services in the 6 months preceding the study were eligible for the study. Fifteen people from each strata were recruited: members who engaged with case management, declined it, or declined it initially but later engaged (N = 45). Participants completed a qualitative interview by phone and a brief health survey online. RESULTS: Across strata, only 22 participants recalled engagement with case management. Members described a variety of life challenges (e.g., chronic health conditions, caregiver responsibilities, and limited finances) and services they desired from their MCO (e.g., stipends for over-the-counter health expenses, improved transportation services, and caregiver assistance). Participants identified direct communication, emotional support, and referrals for resources as benefits of case management.

Describing the Lived Experience and Resource Needs of Individuals With Long COVID.

Individuals with long COVID report diverse symptoms lasting weeks or months after initial infection, causing significant psychosocial distress. Navigating health care interactions are often difficult for these individuals due to the diffuse nature of their symptoms, a lack of effective treatment options, and skepticism from some providers. To better understand these challenges, this study sought to further describe the lived experience of individuals with long COVID. A survey was conducted with individuals evaluated for long COVID at a specialty clinic (n = 200), which included questions about prior conditions, symptoms, use of medical and support services, and information and resource needs. Participants reported a mean of 10.75 persistent symptoms, the most common being fatigue and difficulty concentrating, with broad effects on daily functioning. Participants saw a mean of 5.92 providers for treatment of their symptoms, and 88.5% identified health care providers as a trusted source of information. Interest in research findings (60.5%) and opportunities for participation (47.5%) were moderate and varied by COVID vaccination status. Unvaccinated individuals (n = 27) also reported less trust in government sources of information, less college education, lower household income, and greater likelihood of having public insurance. Our findings suggest that individuals with long COVID experience many ongoing and complex symptoms with diverse effects on daily living; that health care providers are an important source for public health messaging about long COVID; and that unvaccinated individuals are likely to have differing needs and receptiveness to information than vaccinated individuals with long COVID.

Diabetes distress in a Medicaid sample: The role of psychosocial and health-related factors.

AIMS: Diabetes-related distress can negatively affect disease management leading to worse complications, especially among marginalized populations. Prior studies mostly focus on distress' impact on diabetes outcomes, with few examining distress predictors. The current study examined the impact of social needs on distress on its own and after controlling for other socio-demographic, psychosocial, and health factors. METHODS: Adult Medicaid beneficiaries with type 2 diabetes and a recent HbA1c test documented in claims data (<120 days) were recruited for a 12-month social needs intervention trial. Baseline survey data assessed diabetes distress, social needs, psychosocial factors and health factors. Descriptive statistics were obtained, and bivariate and multivariable logistic regression analyses were used to identify predictors of moderate to severe distress. RESULTS: Bivariate analyses revealed social needs, stress, depression, comorbidity and comorbidity burden, poor self-rated health, insulin use, a self-reported HbA1c ≥ 9.0, and difficulty remembering to take diabetes medications were all positively associated with greater odds of diabetes distress; greater social support, diabetes self-efficacy, and age were negatively associated. Four variables remained significant in the multivariate model: depression, diabetes self-efficacy, self-reported HbA1c ≥ 9.0, and younger age. CONCLUSIONS: Targeted distress screening efforts might prioritize people with HbA1c values >9.0, greater depression, and worse diabetes self-efficacy.

Word length negatively predicts recognition memory performance.

We examined how word length affects performance in three recognition memory experiments to resolve discrepant results in the literature for which there are theoretical implications. Shorter and longer words were equated on frequency, orthographic similarity, age of acquisition, and imageability. In Experiments 1 and 2, orthographic length (i.e., the number of letters in a word) was negatively related to hits minus false alarms. In Experiment 3, recognition performance did not differ between one- and two-syllable words that were equated on orthographic length. These results are compatible with single-process item-noise models that represent orthography in terms of features and in which memory representation strength is a product of the probabilities that the individual features have been stored. Longer words are associated with noisier representations than shorter words.

Incidental memory for colour word associates processed in colour naming and reading aloud tasks: is a blue ocean more memorable than a yellow one?

Congruency effects for colour word associates (e.g., ocean) have been reported in Stroop colour naming tasks. However, incidental memory for such words after word reading and colour naming tasks has not been examined. In the current study, participants incidentally recalled colour word associates (e.g., ocean) and neutral words (e.g., lawyer) immediately after naming their font colour (Experiment 1a) or reading them aloud (Experiment 1b). In both tasks, recall was better for congruent colour word associates (e.g., ocean appearing in blue) than incongruent colour word associates (e.g., ocean appearing in green) or neutral items (lawyer appearing in blue). This outcome is consistent with the idea that co-activation of a semantic colour code and a lexical representation strengthens the episodic memory representation and makes it more accessible.