Insurance Type Affects Access to Care for Young Football Athletes with Hip Labrum Tears

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Health Equity

Background:

• Access to orthopedic care is often challenging for patients with Medicaid compared to those with private insurance.
• Limited research exists on insurance-based disparities in accessing care for young athletes with hip labrum tears.

Purpose of the Study:

• To determine if insurance status (Medicaid vs. Blue Cross Blue Shield - BCBS) affects appointment acceptance rates for young athletes with hip labrum tears.
• To identify specific barriers encountered by young athletes with Medicaid seeking orthopedic care for hip labral tears.

Main Methods:

• A standardized script was used to contact 50 orthopedic clinics across 10 states.
• Clinics were contacted twice, once inquiring about an appointment for a young athlete with BCBS and once with Medicaid for a hip labral tear.
• Appointment success rate was the primary outcome, with secondary outcomes including scheduling barriers and wait times.

Main Results:

• All clinics accepted BCBS insurance, while only 32% accepted Medicaid (P<0.0001).
• Appointment success was 100% for BCBS versus 24% for Medicaid (P<0.0001).
• The primary barrier for Medicaid was the requirement for a primary care physician referral (32% of non-accepting clinics).

Conclusions:

• Young athletes with hip labrum tears experience significantly greater difficulty scheduling orthopedic appointments when insured by Medicaid compared to BCBS.
• The necessity of a primary care physician referral represents a substantial barrier to care access for young athletes with Medicaid.
• Findings highlight insurance-related disparities in orthopedic care access for this specific patient population.