Wednesday, March 14, 2012

Medicaid Beneficiaries have more Barriers to Obtaining Primary Care and are More Likely to Make ER Visits than those Individuals with Private Insurance

As the different phases of health care reform are implemented over the next few years, it is anticipated that more people will obtain access to health care in the United States than ever before.  A large number of these individuals will obtain health care through the current Medicaid program.  However, there are many concerns about how these individuals will be able to obtain timely access to care and how it will affect the overall health care system. 

A study recently published in the Annals of Emergency Medicine reports that compared with individuals with private insurance, individuals with Medicaid are more likely to have one or more barriers to obtaining medical care from primary care doctors and end up making more visits to Emergency Rooms for their primary care needs.  They identified 5 barriers that these individuals face:  (unable to get through on the telephone, unable to obtain a timely appointment, long wait in the physician’s office, limited office hours, and lack of transportation).

Some of the solutions the authors offer are to, increase the number of primary care doctors, as well as increase the number and hours of Community Health Centers.  This would aid to increased primary care access for these individuals rather than them having to go the ER.  This also may aid in slowing the current problem of ER overcrowding.

This issue is especially important in states like Washington where there is currently a consideration of not paying for non-emergent medical visits made by Medicaid beneficiaries.  I agree with the authors of this article.  There is definitely a huge need for the increase in the number of primary care doctors and a huge need for the increase of clinics and increase in their hours of operation.  These solutions may aid in reducing the number of primary care visits made in the Emergency Room.

The full article can be found here:
Cheung, PT et. al, National Study of Barriers to Timely Primary Care and Emergency Department Utilization Among Medicaid Beneficiaries, Annals of Emergency Medicine 2012; 20 (1) 1-9;

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