Accessibility to Obstetric Care in South Florida Based on Insurance: A Cross-Sectional Study

Area of Science:

• Obstetrics and Gynecology
• Health Services Research
• Public Health Policy

Background:

• Early prenatal care is crucial for optimal pregnancy and birth outcomes.
• Delayed initiation of care and insufficient visits are linked to increased risks of prematurity, stillbirth, and infant mortality.
• Previous studies indicate women with public insurance access prenatal care later than those with private plans.

Purpose of the Study:

• To determine if public health insurance, specifically Medicaid, limits access to obstetric care for patients in Florida.
• To compare appointment availability and acceptance rates for Medicaid versus private insurance plans.

Main Methods:

• A cross-sectional study analyzed obstetric care access in South Florida's most populated Medicaid zip codes.
• Data was collected via HealthGrades.com, searching for highly-rated obstetricians within a 10-mile radius.
• Researchers simulated appointment requests for fictional patients, recording insurance acceptance (Medicaid, Cigna, UHG) and wait times.

Main Results:

• Only 45.1% of contacted obstetricians accepted Medicaid, compared to 97.2% for UnitedHealthcare and 98.6% for Cigna.
• The average wait time for an appointment was significantly longer for Medicaid patients (17.0 days) than for UnitedHealthcare (12.7 days).
• A statistically significant difference was found in both insurance acceptance rates and appointment wait times between Medicaid and private insurance plans.

Conclusions:

• Medicaid patients in South Florida experience substantially reduced access to obstetric care compared to privately insured individuals.
• This decreased access to prenatal care may contribute to adverse pregnancy and birth outcomes.
• Findings highlight the need for policymakers to consider these access disparities in future Medicaid expansion discussions.