Medicaid Coverage Creates Significant Healthcare Opportunities

April 13, 2018 - Medicaid coverage led to significant healthcare opportunities that rivaled commercial health insurance care quality, according to a new study from AHIP.

Nearly 74 million adults and children who receive Medicaid were found to have significantly better preventive care, clinical care, and provider access than uninsured members. Additionally, Medicaid beneficiaries had similar if not identical quality of care as commercially insured children and adults.

AHIP researchers suggested that the Medicaid program is extremely likely to address gaps in healthcare quality for individuals who are uninsured if they transition to Medicaid coverage. The team explained that Medicaid benefits add tremendous value to addressing health equity challenges for the nation’s must vulnerable populations.

“This new evidence reinforces what insurance providers see every day – Medicaid works for patients and taxpayers,” said AHIP Vice President of Medicaid Policy and Advocacy Rhys Jones. “Medicaid is an important part of America’s safety net and optimizes the use of every dollar invested into the program to ensure those who need help the most get the care they need.”

Commercially insured and Medicaid-covered adults had nearly identical healthcare experiences with greater regularity than uninsured members, the team found.

Eighty-two percent of commercial health plan members and 80 percent of Medicaid beneficiaries reported having a usual source of care. The team found in comparison that only 43 percent of uninsured adults had a usual source of healthcare.

“Significantly more commercial health plan and Medicaid health plan enrollees were always able to access all necessary and needed care or schedule appointments with their providers compared to uninsured individuals,” the team asserted.

Both commercially-insured and Medicaid-insured adults also had a higher rate of preventive healthcare services than non-insured members.

Eighty-four percent of commercial health plan members and 85 percent of Medicaid health plan enrollees had at least one blood pressure test. In contrast, only 54 percent of uninsured people had their blood pressure measured.

Uninsured adults also had significantly lower rates of flu vaccinations than their insured counterparts.

“Although a little over twice as many of people with coverage (44 percent and 39 percent, commercial and Medicaid, respectively) had been vaccinated against the flu, only 17 percent of uninsured people received an annual flu shot,” the team explained.

In addition, the Medicaid program created improved healthcare opportunities for children at substantial rates, the team asserted.

Ninety percent of commercially insured and Medicaid-covered children had access to a provider, compared to 72 percent of uninsured children.

“Furthermore, almost 60 percent of insured children had a general check-up, a well-child visit, or visit to a health care provider where vaccinations were administered,” AHIP added. “By contrast, half of that number of uninsured children (31 percent) had such doctor’s visits in the preceding 12-months.”

A child who had any type of insurance experienced greater preventive opportunities at more desirable rates than uninsured children, AHIP ascertained.

Between 80 to 90 percent of commercially-covered and Medicaid-covered children received preventive care and related guidance from providers.

“Comparatively, 30-40 percent of uninsured children never received such attention from a health care provider during the same period,” the researchers said.

AHIP explained that these findings supplant more evidence that the Medicaid program is a proactive solution towards health equity, which may educate the harshest critics of the program.

Previous studies hypothesized that the Medicaid program did not create effective healthcare outcomes for beneficiaries, but these studies had inconsistencies in sample size and study design, AHIP researchers argued.

“Recent studies of people with Medicaid coverage have found they have access to care and use preventive care services at rates comparable to those with commercial insurance; both groups have far better experiences than the uninsured,” AHIP concluded.

“However, some critics of the Medicaid program have raised questions about patient access to care and quality based on several commonly cited studies that include outdated data and/or methodological weaknesses that challenge the validity and generalizability of their conclusions.”