Medicaid patients have limited access to care for ankle sprains
Click Here to Manage Email Alerts
CHICAGO — Access to care for patients with ankle sprains is more difficult with Medicaid insurance compared with private insurance, especially in Medicaid unexpanded states, according to results of a study presented here.
“For patients with an ankle sprain, it was harder to get access to an orthopedic surgeon if you have Medicaid compared to Blue Cross. That is the take-home point. I think we need to be aware of this. I think for our policymakers, we need to talk about do we need to do something with the amount of that money we pay for Medicaid and access. But we know it is a problem and something we need to work on,” Daniel J. Scott, MD, MBA, of the Medical University of South Carolina, said during a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
The goal was to determine whether individual state Medicaid expansion status, as well as patient insurance status, affected access to care for patients with ankle sprains.
Scott and colleagues selected the Medicaid expansion states of Kentucky, Louisiana, Iowa, Arizona and unexpanded states of North Carolina, Alabama, Wisconsin and Texas. They randomly selected 12 practices from each state using the American Orthopaedic Foot & Ankle Society directory and called each clinic twice to request an appointment for a fictitious 16-year-old patient with a first-time ankle sprain with either in-state Medicaid insurance or Blue Cross Blue Shield (BCBS) private insurance.
In all states, researchers were able to make an appointment at 65.6% of the clinics in the expanded states when calling with BCBS and at 45.8% of the clinics when calling with Medicaid. In the expanded states, researchers were able to make an appointment at 60.4% of the clinics when calling with BCBS and at 47.9% of the clinics when calling with Medicaid, however, the difference was not statistically significant. In the unexpanded states, researchers were able to make an appointment at 70.8% of the clinics when calling with BCBS and at 43.8% of the clinics when calling with Medicaid.
“There might have actually been some impact of expanded vs. unexpanded status,” he said.
Researchers were able to schedule more appointments using BCBS than Medicaid in all states, except Iowa. The waiting period for appointments did not differ by insurance. The main reasons for the denial of appointments were inability to provide an insurance identification number, unaccepted insurance status and lack of a needed referral.
Collapse
Click Here to Manage Email Alerts