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Medicaid access state by state

Nov. 2, 2015, 3:00 PM


Commercial insurance pays health care providers better than Medicaid does. The Affordable Care Act is swelling Medicaid rolls. Will these new beneficiaries find access to care?

Alternately posing as Medicaid beneficiaries, commercial insurance beneficiaries and uninsured self-payers, secret shoppers employed by health policy researchers requested primary care appointments from 6,468 clinics located in 10 U.S. states.

Researchers checked for correlations among insurance status, access to care, clinic staffing of nurse practitioners and physician assistants, and the degree of autonomy assigned to these non-physician providers by scope-of-practice laws in different states.

In the journal Health Economics, Policy and Law, Michael Richards, M.D., Ph.D., M.P.H., and a colleague report that “clinics with more non-physician clinicians are associated with better access for Medicaid patients and lower prices for office visits; however, these relationships are only found in states granting full practice autonomy to these providers. … Relaxing regulations for non-physicians may be an important initiative as U.S. health reforms continue.”

Richards was joined in the study by Daniel Polsky Ph.D., of the University of Pennsylvania. The study was supported by a grant from the Robert Wood Johnson Foundation.

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