New Research Shows Medicaid Is Working

by Rhys Jones

September 6, 2017

Since its inception 50 years ago, Medicaid has served needy families, people with physical, intellectual and developmental disabilities, people with severe mental illness, older adults with chronic diseases, and foster children. Today, this program, which is administered through partnerships between federal and state governments, serves more than 74 million Americans. And more than 70 percent of Medicaid enrollees in 39 states receive their Medicaid benefits through managed care plans.

In recent policy discussions, some have decried Medicaid as a broken system. The evidence proves otherwise. Medicaid is far from broken, and in fact serves its enrollees well. Several recent studies demonstrate that Medicaid enrollees have access to care and are satisfied with their care at levels similar to people with commercial health coverage.

  • A recent study profiled in JAMA Internal Medicine evaluated survey data collected by the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers the Medicare and Medicaid programs. The Consumer Assessment of Health Plans and Systems (CAHPS) survey is widely used by health plans to measure people’s satisfaction with key aspects of the health system, like access to providers and timeliness of care. The study analyzed CAHPS responses in 2014 and 2015 from more than 270,000 Medicaid enrollees surveyed in 46 states and Washington, D.C. The study found that Medicaid enrollees are generally satisfied with their coverage across multiple demographic groups and states. Overall satisfaction with Medicaid was in a range similar to commercial insurance and Medicare. The study also found that there was little evidence that physician participation rates create a barrier to care for most Medicaid enrollees. The authors concluded, “Medicaid enrollees are largely satisfied with their care, and that few perceive their insurance as a major barrier to care. Changes to Medicaid that would result in millions of beneficiaries losing coverage could have major adverse effects.”
  • In July, J.D. Power released its 2017 Managed Medicaid Special Report. The study measured overall enrollee satisfaction with their Medicaid managed care plans in key areas, such as provider choice, coverage and benefits, customer service, and communications, and was based on responses from 2,145 enrollees in Medicaid health plans in 36 states and Washington, D.C. in the first quarter of 2017. On average, Medicaid managed care plan enrollees ranked their overall satisfaction at 78 percent, which is slightly higher than commercial health plan member satisfaction ratings in a similar study. And managed Medicaid programs in four states – Iowa, Tennessee, Arizona, and Indiana – were notable for having especially good access to doctors and hospitals.
  • Kaiser Family Foundation’s recent analysis of National Center for Health Statistics data explored access to care in Medicaid. It found people with Medicaid can access care at rates comparable to people with private health insurance. In fact, 95 percent of children covered by Medicaid or CHIP have a usual source of care, compared to 97 percent of children with private insurance and 69 percent of uninsured children. Children with Medicaid receive services at rates similar to children with private coverage, such as well-child checkups, and primary care and specialist visits within the past year. Nearly 90 percent of non-elderly adults with Medicaid and adults with private insurance have a usual source of care, while less than half of uninsured adults have a usual source. And uninsured people are much less likely than Medicaid enrollees to receive care, and are much more likely to delay or go without needed care due to cost. Adults with Medicaid are as likely as privately insured adults to have a doctor visit and receive specialist care. Among low-income adults (income at or below 250 percent the federal poverty level) with full-year coverage, Medicaid enrollees receive preventive care and cancer screenings at similar rates to those with private health insurance.

These newer studies reinforce the conclusions of earlier studies documenting the value that Medicaid and Medicaid managed care plans provide to Medicaid enrollees in terms of access and satisfaction. For example, a Morning Consult survey commissioned by AHIP in 2016 found that the great majority of Medicaid beneficiaries were satisfied with the access to care and benefits that the Medicaid program provides.

These results show Medicaid continues to deliver on its promise of serving low-income Americans.  This important safety net program clearly plays an important role in ensuring the health of millions of Americans.

The future of the Medicaid program will be discussed later this month at AHIP’s National Conferences on Medicare, Medicaid & Duals. Hear from speakers like Gary Herbert, Governor of Utah; Matt Salo, Executive Director, National Association of Medicaid Directors; and Melanie Bella, former director, Federal Coordinated Health Care Office at CMS. Register today.