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Reviewing Medicaid’s Role in Boosting Patient Access to Care

Medicaid has boosted patient access to care through streamlined enrollment, better access to point of care, improving quality of care, and fostering healthcare innovation.

- Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) have made great strides in increasing patient access to care over the course of the past ten years, according to a recent blog post from the Centers for Medicare & Medicaid Services (CMS).

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The post, written by CMS’s Andy Slavitt and Vicky Wachino, covers the four central ways in which Medicaid has positively impacted patient access to care, including easier enrollment processes.

Presently, patients can enroll for Medicaid via online portal, telephone call, or at a Medicaid office, through a one-step process implemented through the Affordable Care Act (ACA). According to Slavitt and Wachino, nearly 50 percent of all Medicaid enrollees underwent this automated process to obtain healthcare coverage.

Prior to these advances, the process for Medicaid enrollment was significantly more arduous. Enrollees needed to complete several pages of paperwork, personally visit a Medicaid office, and conduct an in-person interview before consideration for the program. By eliminating these hoops to jump through, CMS has helped expand access to healthcare for an increasing number of consumers who need it.

Recent CMS provisions have also increased patients’ access to actual care sites, not just to health insurance. Through better alignment of care offerings between Medicaid providers, CMS has helped more adult patients seek both specialty care and primary care, helping to foster patients’ overall wellness.

“And new rules create real accountability to ensure access to care is sufficient in key specialties,” Slavitt and Wachino wrote. “Thanks in part to the work that CMS and states have done to make sure people have access to health services, adults with Medicaid coverage are just as likely to obtain primary care services as those with private insurance, while experiencing less difficulty paying their medical bills than others.”

While CMS has helped more patients receive healthcare coverage and access care facilities, they have also reportedly boosted care quality. Through the promotion of value-based care and accountable care reimbursement models, the agency has fostered a sense of caring for the whole patient with quality treatment rather than a high volume of tests and procedures.

“Over the last several years, states have undertaken significant efforts through State Innovation Models, integrated care models, and delivery system reform incentive programs to create alignment with physicians and hospitals to provide the highest quality of care,” the pair stated. “And we have proven that when we and states dedicate ourselves to changing the delivery of care, we get results.”

CMS has also worked through innovation centers to help improve care quality. By opening these sites, healthcare professionals have the location and the tools to help boost the way they deliver care to high-needs populations. Particularly, this innovation is happening in the health IT realm.

“To help support these delivery system reforms through improvements to the coordination of patient care, states, with the support of CMS, are working to update legacy IT systems to ones that leverage proven IT methods,” Slavitt and Wachino noted. “This is key in helping to deploy tools, such as electronic health records, that improve the coordination of patient care, further supporting innovative efforts that lead to smarter spending and healthier people.”

All of these advancements in patient access to healthcare have culminated in the recent release of a Medicaid and CHIP final rule, which transforms how these programs align with managed care delivery systems. This will ideally further improve patient access to care.

“These improvements modernize the way these managed care health plans operate so that Medicaid and CHIP continue to provide cost-effective, high quality care to consumers,” the two stated.

Details regarding the final rule will be published in the Federal Register beginning at the start of May.