A new federal report explains why Medicaid patients have difficulty receiving medical care and treatment with doctors who were listed to serve them.
The report from the Department of Health and Human Services inspector general revealed that many of these doctors are not available to treat Medicaid patients with up to more than half of primary healthcare providers unable to offer appointments to enrollees.
The report, which was issued on Tuesday, cited results of a study that assessed the availability of Medicaid managed care providers. For this study, the researchers conducted calls to 1,800 healthcare service providers confirmed by insurers to be supposedly taking Medicaid patients in order to evaluate the availability and timeliness of their appointments for the enrollees.
The findings revealed that many of the physicians were not accepting new Medicaid patients. Many of these doctors could not also be found at their last known addresses, raising questions about the accessibility of medical care for individuals availing of Medicaid coverage under the Obama Administration's Affordable Care Act.
"Our findings demonstrate significant vulnerabilities in provider availability, which is a key indicator for access to care," the report reads [pdf]. "These findings also raise serious questions about the abilities of plans, States, and CMS to ensure that access-to-care standards are met."
The team of investigators led by inspector general Daniel Levinson found that more than a third of the healthcare providers could not be found at their address listed by a Medicaid managed-care plan.
Levinson said that in these cases, the patients who call were told that the practice did not hear of the provider, or that the doctor indeed previously practiced at the location but is already retired or is no longer in practice. Some of these doctors had already left for years before the time of the call.
There were also approximately 8 percent of the providers who were at their listed location but said that they did not participate in the Medicaid health plans that they are supposed to be affiliated. Another 8 percent said they are affiliated with Medicaid but were not accepting new patients.
Only 44 percent of the primary care providers offer appointments compared with 57 percent of the specialists. For these providers, particularly the specialists, wait time could also be an issue as the wait time for an appointment with a specialist is 20 days on average. Primary care providers, on the other hand, have median wait time of 10 days.
