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Patient Access to Care Five Times Higher for Medicaid Patients

The report found that Medicaid patients are five times more likely and CHIP patients four times more likely to have easy patient access to care than uninsured patients.

health insurance patient access to care

Source: Thinkstock

By Sara Heath

- Patients with private health insurance or on Medicaid see better patient access to care and preventive services than patients without any type of health insurance, according to a new report from America’s Health Insurance Plans (AHIP).

These results come after a tumultuous political season for Medicare, Medicaid, and the health insurance exchanges set up as a part of the Affordable Care Act (ACA). Over the past year, debate has centered on the fate of patients who do not have health insurance or who could lose health payer coverage as a part of healthcare policy reforms.

This latest AHIP report contends that patients who do not have some sort of health payer coverage, whether it be commercial or through Medicaid, do not fare as well as those with coverage.

An analysis of MEPS survey data for over 38,000 patients during the 2013 to 2015 timeframe showed significant differences in patient access to care for patients with private Medicaid plans, commercial insurance, and no payer coverage at all.

Adult Medicaid beneficiaries were five times more likely to have a regular source of healthcare compared to patients without coverage.

READ MORE: What Providers Should Know to Improve Patient Access to Healthcare

“Significantly more commercial health plan and Medicaid health plan enrollees were always able to access all necessary and needed care or schedule appointments with their providers compared to uninsured individuals,” the report stated. “In fact, in all cases, adults with coverage had better access to care than their uninsured peers.”

Adult Medicaid beneficiaries were also four times more likely to receive preventive care and other wellness checks than those without insurance.

For example, 85 percent of Medicaid health plan beneficiaries received a blood pressure test during the study period, and 84 percent of commercially-insured patients said the same. Only 54 percent of insured patients received a blood pressure test during the study period.

However, there were some areas for improvement for all three patient cohorts, the report authors noted. Across patients with Medicaid insurance, commercial insurance, and no insurance, few received annual flu vaccines.

Forty-four percent of patients with commercial coverage and 39 percent of patients with a Medicaid plan received an annual flu shot. Only 17 percent of patients without insurance received a flu shot.

READ MORE: Does the ACA Drive Patient Access to Primary Preventive Care?

The benefits of healthcare coverage extended to pediatric patients, as well. Children on Medicaid, CHIP, or commercial insurance were four times more likely to have a usual source of care. Children were between two and three times more likely to receive preventive care than those without payer coverage.

These results fall in line with other industry data, the report authors noted. Numerous other studies have indicated that those with access to some type of healthcare coverage see easier patient access to care and higher rates of patient engagement in preventive care.

There are also some studies that run counter to the current AHIP research results, the investigators conceded.


“Despite this growing body of literature demonstrating the value of Medicaid, critics have attempted to challenge the value of the Medicaid system by examining studies of outcomes of Medicaid patients compared to commercially insured or non-insured patients,” the team said.

“Although the studies summarized above are cited by the critics of the Medicaid system as evidence of poorer outcomes among Medicaid patients, a conclusion that is questionable given the problems in study design, they do, in fact, point out the importance of access to care and the provision of preventive services,” the researchers continued.

READ MORE: Tom Price Comments on AHCA Impact on Patient Access to Care

Additionally, many studies that run counter to the current AHIP research results have some methodological flaws, the team said. Several of these studies also use limited or outdated data, the researchers argued.

These study results point to a need to continue to care for the Medicaid and underinsured population, the researchers said. Although many of these patients are high-risk and can be costly, consistent health payer coverage and access to care has helped improve overall health outcomes, the research team stated.

“Despite the unique challenges associated with caring for the Medicaid population, there is steadily growing evidence in the literature that Medicaid patients have better clinical experiences and outcomes than the uninsured and gaps between Medicaid patients and the commercially insured continue to narrow,” the researchers concluded. “The recent literature paints an encouraging portrait of a Medicaid system that is central to providing access to high-quality care and preventive services for the country’s most vulnerable people.”

Although these results also paint a positive picture of commercial insurance, AHIP representatives contend that the study is ultimately a display of strength for Medicaid.

“This new evidence reinforces what insurance providers see every day – Medicaid works for patients and taxpayers,” said AHIP president of Medicaid Policy and Advocacy Rhys Jones. “Medicaid is an important part of America’s safety net and optimizes the use of every dollar invested into the program to ensure those who need help the most get the care they need.”

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