Patterns in primary health care utilization among individuals with intellectual and developmental disabilities in Florida.

Hall et al. (2007) looked at four years of Florida Medicaid bills for adults on the IDD waiver. They wanted to see who visited a regular doctor and who did not.

The team counted primary care visits and mapped them by region. They used only the billing codes, so no new interviews or tests were done.

Six out of ten adults saw a primary care provider at least once. Four out of ten never did.

Some parts of the state had even lower numbers, showing clear regional gaps.

Slayter (2010) used the same Florida Medicaid files and found the same group also rarely got help for drug or alcohol problems. Together the two papers show a wide service gap across different kinds of care.

Goodwin et al. (2012) looked at Iowa Medicaid kids with IDD and found they were not late for their first dental visit. That sounds opposite, but the Iowa study looked at children and a different service, so the gap may hit only after people age into adult care.

Anonymous (2017) zoomed out to all 50 states and showed that every IDD waiver spends money differently. The Florida finding fits inside that bigger picture: low doctor use in one state may be worse or better elsewhere.

If four in ten clients skip basic check-ups, small problems can snowball into crises that need ER trips or hospital stays. You can build care coordination into plans: schedule the annual physical, track no-shows, and teach families why it matters. One quick win is to add a primary-care referral checklist to every new waiver plan you write.