Access, satisfaction, and utilization in two forms of Medicaid managed care

Prenatal care characteristics and African-American women's satisfaction with care in a managed care organization

This study examined the characteristics of prenatal care affecting women's satisfaction for two groups of African-American women, those with Medicaid insurance and those with commercial insurance, who sought care through a large managed care organization in the Midwest. African-American pregnant managed care patients (n = 400), regardless of payer status, were more satisfied when their providers spent more time with them and when their providers engaged them by explaining procedures, asking them questions, and answering their questions. Satisfaction was also higher for both Medicaid (n = 125) and commercially insured women (n = 275) when the waiting room was clean and comfortable. The care characteristics most important to an African-American woman's satisfaction with prenatal care do not appear to be dependent on her payer status, nor do they seem to be particularly dependent on the financial arrangements of her care provider. While improvements in health care delivery tend to focus on increasing technical proficiency to improve pregnant women's satisfaction with care, prenatal care providers should focus on improvements in patient-provider communication, as well as features of the prenatal care setting (e.g., cleanliness, waiting times, availability of ancillary services).