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Unequal Care Access for Children With Public Insurance

Disparities exist in providers' acceptance of public insurance compared to private insurance

THURSDAY, June 16 (HealthDay News) -- Access to outpatient care is restricted for children with public insurance compared to those with private insurance, according to a study published in the June 16 issue of the New England Journal of Medicine.

Joanna Bisgaier, M.S.W., and Karin V. Rhodes, M.D., from the University of Pennsylvania in Philadelphia, measured the access to outpatient pediatric specialty care to identify disparities in providers' acceptance of Medicaid and the Children's Health Insurance Program (CHIP) compared to private insurance. Data were collected by research assistants posing as mothers who made 546 paired calls to 273 clinics covering eight specialties in Cook County, Ill., to schedule an appointment for a child needing specialty care, between January and May 2010. These calls were separated by one month and varied only by insurance status (private versus MedicaidCHIP insurance).

The investigators identified significant disparities across all specialties in provider acceptance of MedicaidCHIP compared to private insurance. The appointment was denied to significantly more MedicaidCHIP callers compared to privately insured callers (66 versus 11 percent; relative risk, 6.2). Among 89 clinics that scheduled appointments for both insurance types, MedicaidCHIP enrollees had to wait significantly longer (22 days) than privately insured children.

"We found a disparity in access to outpatient specialty care between children with public insurance and those with private insurance. Policy interventions that encourage providers to accept patients with public insurance are needed to improve access to care," the authors write.

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