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Access to care: how much difference does Medicaid make?

M L Berk, C L Schur

    Health Affairs (Project Hope)
    |June 25, 1998
    PubMed
    Summary
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    Medicaid enrollees faced significant barriers to care, reporting difficulty obtaining services more often than privately insured individuals. However, access for Medicaid recipients was better than for the uninsured across most measures.

    Area of Science:

    • Health Services Research
    • Health Economics
    • Public Health Policy

    Background:

    • Access to healthcare is a critical determinant of health outcomes.
    • Insurance status significantly impacts healthcare access and utilization.
    • Understanding disparities in care access among different insurance groups is essential for policy development.

    Purpose of the Study:

    • To compare healthcare access among individuals with private insurance, Medicaid, and no insurance.
    • To analyze differences in having a usual source of care, obtaining needed care, and physician visit frequency.
    • To identify specific barriers faced by different insurance groups.

    Main Methods:

    • Utilized data from the 1994 Robert Wood Johnson Foundation National Access to Care Survey.

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  • Employed statistical analysis to examine the likelihood of access measures based on insurance status.
  • Compared individuals with private insurance, Medicaid, and uninsured persons.

    • Main Results:

    • Medicaid enrollees were half as likely as uninsured individuals and twice as likely as privately insured individuals to report difficulty obtaining services.
    • Inability to obtain needed services showed consistent disparities across insurance groups.
    • For other access measures, Medicaid recipients' experiences more closely aligned with those of privately insured individuals than the uninsured.

    Conclusions:

    • Medicaid coverage presents significant access challenges, particularly in obtaining needed services.
    • While disparities exist, Medicaid access is generally superior to being uninsured.
    • Findings highlight the need for continued efforts to improve healthcare access for vulnerable populations insured by Medicaid.