Tuesday, June 28, 2011

Barriers to Access for Children on Medicaid


According to the New England Journal of Medicine:

"Expansions of Medicaid and the Children’s Health Insurance Program (CHIP) are designed to extend access to high-quality medical care to all U.S. children. However, evidence suggests that the 37 million children covered by Medicaid–CHIP are less likely to receive specialty care than children covered by commercial insurance."

Access Disparities for Medicaid Children
Researchers have found that medical specialists are more likely to deny appointments to children with Medicaid. Assistants posed as mothers and made phone calls to 273 clinics in Cook County, IL. Only 11% of privately insured individuals were denied appointments, while 66% of the children on Medicaid were denied. 

Disparities were also present in waiting times. At the 89 clinics that accepted both insurances, there was a 42 day wait for a child on Medicaid as opposed to a 20 day wait for those with private insurance. 


Possible reasons for the differences include lower reimbursement rates for Medicaid and more problems with the payment process.

Researchers say that the results are not likely to be unique to Cook County. The study was published in the New England Journal of Medicine.

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