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Evaluating the network adequacy of vision care services for children in Arizona: A cross sectional study
Rizwana Biviji1, Nikita Vora2, Nalani Thomas1
1College of Health Solutions, Arizona State University, Phoenix, AZ.
Insights
Many Arizona children face barriers to essential vision care. A study found significant gaps in pediatric vision network adequacy, particularly for those with Medicaid (AHCCCS), impacting access to timely and comprehensive services.
Area of Science:
- Pediatric Ophthalmology
- Public Health
- Healthcare Access
Background:
- Childhood vision challenges are a major cause of disability, affecting learning and development.
- Timely diagnosis and treatment are crucial, but access to quality pediatric vision care is often limited by network inadequacies.
- Ensuring adequate vision care networks is vital for children's overall well-being and educational success.
Purpose of the Study:
- To evaluate the adequacy of pediatric vision care networks within Arizona.
- To identify specific gaps in children's access to vision care services across the state.
- To inform strategies for improving vision care accessibility for all children in Arizona.
Main Methods:
- A cross-sectional study utilizing a "secret shopper" phone survey methodology.
- Practices accepting Arizona Health Care Cost Containment System (AHCCCS) and commercial insurance were contacted.
- The survey assessed provider directory accuracy, appointment availability, bilingual services, age ranges served, and geographic distribution.
Main Results:
- An average wait time of 13 days for appointments was observed for both AHCCCS and commercial insurance.
- A significant barrier exists, with up to 74% of practices not serving children with AHCCCS.
- Less than half (41%) of practices offer services to young children aged 5 and under.
Conclusions:
- Findings highlight critical deficiencies in Arizona's pediatric vision care network adequacy.
- There is an urgent need to enhance access, particularly for underserved populations including racial/ethnic minorities, low-income families, and rural residents.
- Improving network adequacy is essential to ensure equitable access to crucial vision services for all children.
Background:
Vision challenges are among the most prevalent disabling conditions in childhood, affecting up to 28% of school-age children. These issues can impact the development, learning, and literacy skills of affected children. While vision problems are correctable with timely diagnosis and treatment, insufficient networks can impede children's access to comprehensive, and high-quality care.
Objective:
The study aims to determine where pediatric vision care network adequacy exists in the state of Arizona and where there are gaps in receiving vision care for children.
Methods:
This cross-sectional study assessed the adequacy of pediatric vision care networks in Arizona through a "secret shopper" phone survey. Calls were made to practices that accept Arizona's Medicaid program, Arizona Health Care Cost Containment System (AHCCCS) and/or commercial insurance. Providers were contacted following a standardized script to schedule routine appointments on behalf of 10 and 3-year-old patients enrolled in either Medicaid or commercial health insurance plans. The study examined various components of children's access to vision care services, including the reliability of provider directory information, time until the next available appointment, bilingual service offerings, ages served, region of practice and types of care available.
Results:
A total of 556 practices in Arizona were evaluated through simulations as patients on AHCCCS, and 510 practices were assessed through simulations as patients with commercial health insurance plans. The average wait time for the next available appointment was 13 days for both insurance types. Alarmingly, up to 74% of vision care practices in Arizona do not serve children covered by AHCCCS. Furthermore, only 41% provide services to children 5 years and younger.
Conclusions:
Our findings underscore the need to improve access to vision care services for children in Arizona, especially racial/ethnic minorities, low-income groups, and rural residents.
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