Sunday, 19 May 2019

Medicaid Enrollees See Better Patient Experiences, Care Quality

patient experiences

Source: Thinkstock

By Sara Heath

– Patients with chronic illness who are enrolled in the Medicaid program tend to have better patient experiences than those without insurance coverage, according to a new study from America’s Health Plans (AHIP).

Specifically, patients with chronic illnesses such as diabetes, asthma, or serious mood disorders who are covered by some form of a Medicaid plan receive care that is comparable to a commercial health plan, the AHIP researchers said. In contrast, patients with no insurance coverage whatsoever tend to experience lower quality care.

These results indicate the value the Medicaid program brings to the some 75 million Americans who are insured by it or the Children’s Health Insurance Program (CHIP).

“Health insurance providers know that Medicaid must work for the people who rely on it—and the hardworking taxpayers who pay for it,” Matt Eyles, AHIP president and CEO, said in a statement. “This new report proves that Medicaid works, and adds to a growing body of evidence that Medicaid is an essential, critical safety net for millions of Americans.”

The report specifically looked at pediatric patients with asthma and adult patients with diabetes, major depressive disorder, or bipolar disorder. Using data from between 2013 and 2015, the researchers looked at whether these patients received care that was consistent with clinical quality guidelines. Receiving quality care can have important impacts on US healthcare spend, the researchers stated.

“Ensuring that patients receive prompt, effective care to manage these chronic conditions will result in better health and financial stability for these Americans and their families, as well as a stronger US economy,” the AHIP researchers explained.

Medicaid beneficiaries received inhalers and other treatments at a higher rate than those without insurance coverage, the researchers found. Fewer than 5 percent of uninsured patients received an inhaler, compared to over 30 percent of patients with Medicaid coverage.

Uninsured patients also visited the emergency department (ED) or other doctors more frequently than those with Medicaid or commercial insurance.

Care quality was better for patients with diabetes or a major mood disorder, the researchers continued. There was little difference in medication prescription and access between patients with commercial insurance, Medicaid, or no insurance.

This is likely due to the cost of medication and the need for medication.

Medications for major mood disorders tend to be relatively less expensive than other drugs, the researchers explained. This means that cost is less of an access barrier for these types of drugs.

And diabetes medication is essential for daily life. While a patient with asthma can go without medication (albeit with difficulty), a diabetic patient cannot live without her medications. Uncontrolled blood glucose levels can be life-threatening, meaning that these patients tend to gain access to their medications out of pure necessity.

Disparities in care quality did emerge for patients with diabetes or major mood disorder with different types of insurance, however.

For example, diabetic patients with commercial insurance or Medicaid received better chronic disease management than uninsured patients. While patients made diet alterations at similar rates, those with insurance received preventive screenings more frequently. Screenings included eye exams, foot exams, and cholesterol tests.

Medicaid beneficiaries with major mood disorder were more likely to receive the combination medication and psychotherapy treatment to manage their illnesses.

Of note, Medicaid patients fared the best out of both uninsured and commercially insured patients. This is a key finding because in most other categories, commercially insured patients still did better than Medicaid enrollees.

These results indicate the value the Medicaid program brings to the patient experience, the report authors said. Specifically, these study results can advocate for the continued funding of the Medicaid program. In recent years, critics have been calling into question the efficacy of the Medicaid program and whether it set beneficiaries on the best path to physical, mental, and economic health.

The Medicaid program is key for serving safety-net populations, the report authors asserted.

“The proposition that having Medicaid coverage is somehow detrimental to one’s health is simply not supported by the clinical experiences described in this and other studies. Indeed, results from this study suggest that quite the opposite is true,” the researchers concluded.

“Medicaid is an essential program that helps millions of Americans get the care they need to stay healthy and productive. It plays a valuable role in strengthening our society – from keeping children healthy to ensuring seniors receive the care they need.”


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