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GAO: Medicaid, privately insured patients have same access to care

More than 3% of beneficiaries struggled with accessing care

Topics: Medicaid, Reimbursement, Finance, Medicare, Payer Relations

November 21, 2012

Medicaid beneficiaries' access to medical care is comparable to individuals with private insurance even though the government program reimburses physicians at a lower rate, according to a Government Accountability Office (GAO) report.

The report found that between 2008 and 2009:

  • 3.7% of Medicaid beneficiaries had difficulty accessing medical care, compared with 3.0% of people with private coverage and 10.4% of uninsured individuals;
  • 2.7% of Medicaid beneficiaries had difficulty obtaining prescription drugs, compared with 2.4% of people with private coverage and 5.6% of uninsured individuals; and
  • 5.4% of Medicaid beneficiaries had difficulties accessing dental care, compared with 3.7% of people with private coverage and 12.3% of uninsured individuals.

The GAO report noted that the disparity in access to medical care and prescription drugs between Medicaid beneficiaries and privately insured patients did not reach statistical significance. Further, the relatively large gap in regard to dental care is likely to do with the number of states that do not include dental coverage in their benefit package.

However, the report noted that children typically have equal access to health care regardless of their source of insurance, while adults enrolled in Medicaid reported greater difficulties accessing care than adults with private coverage. About 7.8% of adult Medicaid beneficiaries reported difficulty obtaining care, compared with 3.3% of similar adults with private insurance, the report found.

In addition, the GAO report discovered that the primary factor that prevents patients from seeing a physician is a lack of transportation, which was more likely to be a challenge for people on Medicaid (Kliff, "Wonkblog," Washington Post, 11/19).

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