6 research outputs found
The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations
Intimacy negotiated: the management of relationships and the construction of personal communities in the lives of bisexual women and men
Bringing into dialogue conceptual literature on bisexuality, intimacy, and personal community, this article illuminates the lived experiences of 80 bisexual women and men in the UK. The data were collected through questionnaire and individual interview. The article discusses two empirical themes, beginning with the participants' narratives on their engagement with the dominant sexual and gender order – which hegemonizes 'monosexuality' and 'compulsory monogamy' – in their negotiation of relational intimacy. This is followed by an exploration of the features and functions of their personal communities, especially the significance of friendships. The article argues that, despite the ambivalence and misperception surrounding bisexuality, the participants enacted creative agency in negotiating intimacy and social support in their everyday lives
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The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations
Background: Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. Methods: We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Findings: Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Conclusions: Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support