July 13, 2017

Medicaid beneficiaries generally pleased with coverage, survey finds

Daily Briefing

Medicaid beneficiaries appear largely satisfied with their health care coverage, according to a research letter published Monday in JAMA Internal Medicine.

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Analysis details

For the analysis, researchers at the Harvard T.H. Chan School of Public Health reviewed CMS' Medicaid Consumer Assessment of Healthcare Providers and System survey conducted from December 2014 to July 2015. The survey included responses from a nationally representative sample of 272,679 Medicaid beneficiaries.

The researchers used the data to estimate Medicaid beneficiaries':

  • Ability to access needed care in the last six months;

  • Access to a usual source of care other than the ED; and

  • Overall health care rating—which ranged from zero for the "worst health care possible" to 10 for the "best health care possible."

The researchers said limitations of the analysis included the survey's low response rate of 23.6 percent and the survey's use of pre-Affordable Care Act enrollment to define the sample.

Findings

Overall, the analysis found Medicaid beneficiaries were largely content with their health care coverage, including those in both Medicaid expansion and non-expansion states.

The researchers found overall health care satisfaction among Medicaid beneficiaries was within a similar range as overall health care satisfaction among individuals enrolled in commercial insurance and Medicare.

For example, the researchers found 46 percent of Medicaid beneficiaries gave their health care coverage a score of 9 or 10, compared with 50.9 percent of individuals enrolled in a commercial health care plan. The researchers also found Medicaid beneficiaries on average rated their overall health care a score of 7.9, compared with an average satisfaction score of 8.6 among Medicare beneficiaries.

In terms of access to care, the researchers found:

  • 84 percent of Medicaid beneficiaries said they were able to access care they or their physicians deemed necessary in the past six months; and

  • 83 percent reported that they had a usual source of care other than the ED.

Overall, the researchers found 3 percent of Medicaid beneficiaries were unable to access care because of wait times or physicians not accepting their health care coverage.

While satisfaction with Medicaid was similar between beneficiaries in Medicaid expansion and non-expansion states, the researchers found the average share "of beneficiaries able to get all needed care was significantly higher in Medicaid expansion states than in non-expansion states." According to the analysis, a mean percentage of 85.2 percent of Medicaid beneficiaries were able to get all the care they needed in expansion states, compared with 81.5 percent in non-expansion states.

Michael Barnett, a co-author of the analysis and an assistant professor of health policy and management at Harvard, said, "Our findings confirm that Medicaid programs are fulfilling their mission to provide access to necessary medical care." He added, "The debate on the future of Medicaid has largely marginalized a crucial voice: the perspective of enrollees" (Frellick, Medscape, 7/10; Harvard T.H. Chan School of Public Health release, 7/10; Barnett/Sommers, JAMA Internal Medicine, 7/10).

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No matter the outcome of the debate over the future of the Affordable Care Act and Medicaid, the likely renewed focus on delivery system costs will make further clinical efficiency an imperative.

To help you and your clinical teams operate in this uncertain time, we've created The Clinical Leader's Resource Guide. Inside you'll find the information and no-regrets strategies needed to support clinical outcomes and financial success in any regulatory environment.

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