Children with Medicaid Insurance Have Longer Wait Times

Individuals in the Spina Bifida Community receiving Medicaid have often expressed concern to SBA that they sometimes feel they receive lesser standards of care because they carry public health insurance. This long held belief is supported by a recent New England Journal of Medicine article finding a disparity in access to outpatient specialty care between children with public insurance and those with private insurance.

The article details the results of a study that emphasizes the need to determine whether provider acceptance of Medicaid – CHIP (Children’s Health Insurance Program) coverage is an independent barrier to outpatient specialty care for children in the current health care market.

The Study
The New England Journal of Medicine, reports that between January and May 2010, research assistants called a random sample of clinics representing eight specialties in Cook County, Illinois, which has a high proportion of specialists. Callers posed as mothers of pediatric patients with common health conditions requiring outpatient specialty care. Two calls, separated by one month, were placed to each clinic by the same person with the use of a standardized clinical script that differed by insurance status.

The study completed 546 paired calls to 273 specialty clinics and found significant disparities in provider acceptance of Medicaid–CHIP versus private insurance across all tested specialties. Overall, 66% of Medicaid–CHIP callers were denied an appointment as compared with 11% of privately insured callers. Among 89 clinics that accepted both insurance types, the average wait time for Medicaid–CHIP enrollees was 22 days longer than that for privately insured children.

Researchers found children with Medicaid were far more likely than those with private insurance to be turned away by medical specialists or be made to wait more than a month for an appointment, even for serious medical problems.

Resources
Children on Medicaid Shown to Wait Longer for Care

Auditing Access to Specialty Care for Children with Public Insurance