Kids with public insurance denied appointments, had longer waits
December 6, 2011By Carolyn Beeler
The number of children covered by public insurance is growing as the economy continues to flounder. In Chicago, research shows children covered by state-run Children's Health Insurance Program or Medicaid are more likely to be denied appointments with specialists, or face long waits to see them.
Researchers posing as parents called nearly 300 specialty practices in Cook County, Illinois, for a study last year. They asked for appointments for kids with problems such as diabetes, seizures, or broken bones.
Dr. Karin Rhodes, an author of the study and director of emergency care policy research at the University of Pennsylvania, said when asked what kind of insurance they had, many simply were turned away.
"We found that two-thirds of children with Medicaid-CHIP were unable to get an appointment at all," Rhodes said.
Rhodes said the lower reimbursement rates and red tape that come with this coverage mean many clinics simply refuse to see kids with public insurance.
Academic medical centers and affiliated Children's Hospitals often have missions that stress serving low-income patients, and they receive federal funds tied to that care. In a new analysis, Rhodes found patients were about half as likely to face discriminatory denials at these hospitals. However, wait times for kids on CHIP or Medicaid were 40 days longer than those with private insurance.
"We found that academic medical centers had less discrimination in a child's ability to get an appointment, but that children with Medicaid and CHIP faced much longer wait times, so they discriminated differently." she said.
Dr. Steve Berman, professor of pediatrics at the University of Colorado School of Medicine, said the longer wait times are a result of hospitals trying to cope with those lower reimbursement rates.
"They've said we're going to place monthly limits on the number of publicly insured patients that we'll take in a given month so that we can save enough appointment slots for patients that have commercial insurance," Berman said.
Rhodes says similar data are not available for the Philadelphia area. Nationwide, she said, collecting data on access and appointment wait times could help policy makers incentivize seeing kids covered by public insurance in a timely manner.