Medicaid beneficiaries report high satisfaction, access to care
- A recent survey of Medicaid beneficiaries found 84% of enrollees said they were able to get all the care they needed in the past six months and 83% said they had a regular source of care, according to a research letter published online Monday in JAMA Internal Medicine.
- The data from the first ever Medicaid Consumer Assessment of Healthcare Providers and System showed “little evidence that low physician participation rates are a key barrier to care” from most enrollees.
- Beneficiaries gave their overall healthcare an average rating of 7.9 on a 0 to 10 scale. Across all demographic groups, ratings ranged from 7.6 to 8.3.
The survey comes as the Medicaid program faces a potential restructuring, including massive funding cuts and an end to Medicaid expansion. Republicans in the House and Senate have put forward such proposals as they attempt to repeal and replace the Affordable Care Act (ACA), but are struggling to come to a consensus on the legislation.
The bill currently being discussed would cut Medicaid spending by $772 billion over 10 years, resulting in an enrollment decrease of 15 million, according to the Congressional Budget Office.
Those trying to restrict Medicaid have argued low reimbursement rates keep many providers from participating. But this survey, and others, show that beneficiaries have increased access to care, which has improved since the ACA was implemented.
The Medicaid satisfaction rates are slightly lower than 2013 rankings from people with commercial insurance and Medicare beneficiaries. Rates were similar in expansion and non-expansion states, although satisfaction rates were higher in expansion states by a statistically significant amount.
Medicaid expansion states have generally seen greater access to care, more affordable care and significantly lower uninsurance rates. Hospitals have also reported less uncompensated care. Governors in states that have benefited from expansion, including some Republicans, are fighting the bills in Congress that would phase out the program.
“In summary, we found that Medicaid enrollees are largely satisfied with their care, and that few perceive their insurance as a major barrier to care. Changes to Medicaid that would result in millions of beneficiaries losing coverage could have major adverse effects,” the authors wrote.
The survey was administered by the CMS from December 2014 to July 2015 and garnered a response rate of 23.6%. It did, however, rely on enrollment files instead of less reliable self-reported data and had a larger sample size that many similar surveys, the authors said.
- JAMA Internal Medicine A National Survey of Medicaid Beneficiaries’ Expenses and Satisfaction With Health Care
- Healthcare Dive 5 highlights from the Senate's ACA replacement bill
- Healthcare Dive Why (even red) states are expanding Medicaid and what that means for health systems
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