Marks Sarah J, Vega Valentina, Zhu David, Shadowen Hannah, Harrell Ashley, Lowe Jason, Mitchell Andrew, Barnes Andrew J, Cunningham Peter J
Virginia Commonwealth University, 830 E Main St, Richmond, VA 23219. Email:
Am J Manag Care. 2025 Jun 1;31(6):e159-e166. doi: 10.37765/ajmc.2025.89752.
Medicaid managed care organization (MCO) care coordinators play a crucial role in assisting high-need Medicaid members with substance use disorder (SUD) and facilitating their connections with medical and social services. This study assessed challenges faced by care coordinators serving patients with SUD, including the types and frequencies of barriers, associated care coordinator and patient factors, and their relationship with burnout and job satisfaction.
Web-based survey data from 322 Virginia Medicaid MCO care coordinators.
Coordinators rated 15 barriers related to providing services to patients with SUD. Principal components analysis (PCA) identified 3 subscales categorizing these challenges (challenges accessing resources, administrative and regulatory burden, and data integration). Multivariable linear regression explored associations between coordinator and patient factors and subscales for categories of barriers. Pearson correlations were used to examine the relationship between these barriers and job satisfaction.
Coordinators reported a high frequency of challenges in many care coordinating activities: Between 49% and 82% reported each barrier as "somewhat" of a problem or a "major" problem. Using PCA, 3 main categories of barriers were identified. Having a high proportion of patients with SUD was associated with greater difficulties in accessing resources (P < .01) and data integration issues (P < .05), and working for specific MCOs was associated with all 3 categories of barriers (P < .05). Job satisfaction and burnout were correlated with all 3 categories as well and were most strongly associated with administrative and regulatory burden.
Care coordinators face multiple challenges serving Medicaid members, particularly those with SUD. State-level Medicaid policies supporting care coordinators may help.
医疗补助管理式医疗组织（MCO）的护理协调员在协助有药物使用障碍（SUD）的高需求医疗补助成员以及促进他们与医疗和社会服务的联系方面发挥着关键作用。本研究评估了为患有SUD的患者提供服务的护理协调员所面临的挑战，包括障碍的类型和频率、相关的护理协调员和患者因素，以及它们与倦怠和工作满意度的关系。
来自322名弗吉尼亚医疗补助MCO护理协调员的基于网络的调查数据。
协调员对与为患有SUD的患者提供服务相关的15个障碍进行评分。主成分分析（PCA）确定了3个分量表，对这些挑战进行分类（获取资源的挑战、行政和监管负担以及数据整合）。多变量线性回归探讨了协调员和患者因素与障碍类别的分量表之间的关联。使用Pearson相关性来检验这些障碍与工作满意度之间的关系。
协调员报告称，在许多护理协调活动中存在高频挑战：49%至82%的人将每个障碍报告为“有点”问题或“主要”问题。通过PCA，确定了3个主要障碍类别。患有SUD的患者比例较高与获取资源方面的更大困难（P < 0.01）和数据整合问题（P < 0.05）相关，而为特定的MCO工作与所有3类障碍相关（P < 0.05）。工作满意度和倦怠也与所有3个类别相关，并且与行政和监管负担的关联最为强烈。
护理协调员在为医疗补助成员提供服务时面临多重挑战，尤其是那些患有SUD的成员。支持护理协调员的州级医疗补助政策可能会有所帮助。
