By Wesley Prater
The GAO recently released a report on access to care for children covered by Medicaid and CHIP. The researchers surveyed specialty care physicians and rural and urban area primary care physicians to examine Medicaid and CHIP enrolled children’s access to both primary and specialty care. The GAO report, required under CHIPRA, also looked into the physicians’ willingness to serve children who were insured by Medicaid or CHIP.
Some of the important findings include:
* Most physicians (78%) are enrolled as Medicaid and CHIP providers and are serving children covered by these plans.
* Primary care physicians (83%) are more likely to be Medicaid and CHIP providers than are specialists (71%).
* All physician types analyzed were more willing to accept privately insured children as new patients than new Medicaid and CHIP patients. (However, rural primary care physicians were more willing than urban primary care physicians to accept children in Medicaid and CHIP as new patients.)
* The wait times experienced by children covered by Medicaid, CHIP and private insurance were similar.
* Physicians not serving Medicaid and CHIP children believed that administrative issues (such as low and delayed reimbursement, burdens with billing and provider enrollment requirements, and difficulty referring patients) were the primary reasons not to serve Medicaid and CHIP children.
* 84% of physicians experience difficulties referring children in Medicaid and CHIP to specialists versus just 26% of physicians referring privately insured children.
It’s no secret that physicians are more willing to serve privately insured children and that there are access issues for Medicaid and CHIP beneficiaries – especially when it comes to specialists. But we need to keep in mind that overall, Medicaid and CHIP are strong programs. My colleague, Joan, recently blogged about a study showing the benefits of Medicaid. Just like with anything else, there’s room for improvement, but the proposed cuts being discussed here in D.C. surely aren’t going to help us reach that level of improvement. Policymakers should place more focus on ensuring that our children’s coverage is strengthened rather than weakened.
