Primary Care Appointment Availability for Medicaid Patients: Comparing Traditional and Premium Assistance Plans
In 2014, Arkansas and Iowa expanded their Medicaid programs and enrolled many of their adult beneficiaries in commercial Marketplace plans. This study suggests that this “private option” may make it easier for new Medicaid patients to get primary care appointments.
As a recipient of the Alice Hersh Scholarship, I had the privilege of attending AcademyHealth’s 2015 National Health Policy Conference in Washington D.C. In addition to many interesting sessions, I had the opportunity to meet many leaders in the health care space, from health services researchers and policy makers to providers and business leaders.
Did the two-year Medicaid “fee bump,” fully financed by the federal government, succeed in its goal of improving primary care availability for growing numbers of Medicaid patients? Most states, facing the decision of whether to use state funds to continue to pay for Medicaid primary care services at Medicare levels, were unconvinced, and Medicaid fees returned to previous levels in 34 states as of January 1, 2015.
A recent report from the Office of Inspector General (OIG) found significant ongoing challenges in access to care for enrollees in Medicaid managed care (MMC). Through “mystery shopper” calls to 1,800 primary care and specialty care providers on state provider lists, OIG found that only 49% of providers offered an appointment across 32 states. Primary care providers offered appointments at a lower rate (44%) than specialty care providers (57%).