Medicaid Enrollees Report Satisfaction, Good Access

Marcia Frellick

July 10, 2017

Medicaid enrollees who participated in a new national survey reported that they were generally satisfied with coverage, and most said they obtained the care they needed.

Only 3% reported not being able to get care because of wait times or because physicians would not take their insurance.

Overall, they rated their care at 7.9 on a 10-point scale (in which 10 is the best), and 84% said they were able to get the care they or their physician felt was necessary in the past 6 months. Eighty-three percent had a usual source of care other than the emergency department.

In rating their Medicaid coverage, 46% gave it a 9 or 10; only 7.6% gave scores less than 5, according to findings published online July 10 in a research letter in JAMA Internal Medicine.

Michael L. Barnett, MD, and Benjamin D. Sommers, MD, PhD, from the Harvard T. H. Chan School of Public Health in Boston, Massachusetts, analyzed data from the first Consumer Assessment of Healthcare Providers and System (CAHPS) survey (n = 272,679) administered by the Centers for Medicare & Medicaid Services. The survey was conducted in 46 states and Washington, DC, from December 2014 to July 2015.

"Changes to Medicaid that would result in millions of beneficiaries losing coverage could have major adverse effects," the authors conclude.

More enrollees in Medicaid expansion states (85.2%) than nonexpansion states (81.5%) reported being able to get all needed care.

The Centers for Medicare & Medicaid Services sampled four groups of adults enrolled in Medicaid as of fall 2013: people with disabilities; patients enrolled in both Medicaid and Medicare; nondisabled adults in managed care; and nondisabled adults in fee-for-service care. The response rate was 23.6%.

Those most likely to say they got all the care they needed were those dually eligible (86.9%). The disabled Medicaid recipients were least likely of the four groups to answer that way (80.2%).

Those with dual eligibility were most likely to have a usual source of care (88.9%); nondisabled adults in fee-for-service care were least likely (77.5%).

"Overall health care satisfaction in Medicaid was in a similar range, though slightly lower, than benchmarks from 2013 CAHPS surveys in other populations, including those with commercial insurance (50.9% with ratings of 9 or 10) and Medicare (8.6 mean satisfaction score)," the authors write.

The researchers say limitations include a low response rate and the fact that they used pre–Affordable Care Act enrollment figures to frame the sample.

The authors have disclosed no relevant financial relationships.

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