Medicaid Patients Have Greater Difficulty Scheduling Health Care Appointments Compared With Private Insurance Patients: A Meta-Analysis

Abstract

Medicaid patients are known to have reduced access to care compared with privately insured patients; however, quantifying this disparity with large controlled studies remains a challenge. This meta-analysis evaluates the disparity in health services accessibility of appointments between Medicaid and privately insured patients through audit studies of health care appointments and schedules. Audit studies evaluating different types of outpatient physician practices were selected. Studies were categorized based on the characteristics of the simulated patient scenario. The relative risk of appointment availability was calculated for all different types of audit scenario characteristics. As a secondary analysis, appointment availability was compared pre- versus post-Medicaid expansion. Overall, 34 audit studies were identified, which demonstrated that Medicaid insurance is associated with a 1.6-fold lower likelihood in successfully scheduling a primary care appointment and a 3.3-fold lower likelihood in successfully scheduling a specialty appointment when compared with private insurance. In this first meta-analysis comparing appointment availability between Medicaid and privately insured patients, we demonstrate Medicaid patients have greater difficulty obtaining appointments compared with privately insured patients across a variety of medical scenarios.

Prevalence of Rheumatoid Arthritis and Drug Dispensing Patterns Among Medicaid and Medicaid–Medicare Dually Eligible Beneficiaries in Puerto Rico

“…The current study used beneficiaries from the Medicaid and Medicaid-Medicare dually eligible programs in Puerto Rico, whereas previous studies have used administrative claims data sets based on information from private health insurance (17,18). Individuals entitled to publicly funded health insurance have reduced access to care compared to privately insured beneficiaries, possibly leading to underestimation in the prevalence of RA (27,28).…”

Rate and Modifiable Predictors of 30-Day Readmission in Patients with Acute Respiratory Distress Syndrome in the United States

“…Interestingly, we also observed a similar phenomenon in ARDS index hospitalizations. It is known that Medicaid patients have greater difficulty obtaining appointments in comparison to privately insured patients [ 17 ]. We postulate that privately insured patients have a better follow-up compared to others and hence, they had lower readmission rates in our study.…”

Trends in Compensation for Primary Care and Specialist Physicians After Implementation of the Affordable Care Act

“…Although the ACA has expanded insurance to millions of Americans, patients with Medicaid still face significant challenges accessing primary care appointments because of Medicaid's low reimbursement levels. 3 A limitation of the MGMA sample was the overrepresentation of physicians from larger medical groups, which could overestimate the observed increases in compensation, because physicians from larger systems or hospitals tend to earn more money than those in private practice. 4 In conclusion, this study found that compensation both for PCPs and for specialty physicians has increased since the ACA was implemented.…”