Medicaid patients may not have adequate access to follow-up orthopedic care, according to a study published in Academic Emergency Medicine.
The researchers used a standardized script to place phone calls to eligible general orthopedic practices located in Texas. During the calls, they requested follow-up care for an ankle fracture that had been treated in a local emergency department on an outpatient basis. The scripts varied by insurance status: callers either stated they had private insurance, Medicaid or were uninsured.
Here's what you need to know:
1. The appointment success rate was 83.1 percent for privately-insured callers, 81.4 percent for uninsured callers and 14 percent for Medicaid callers. Fewer than one in seven Medicaid callers were able to schedule orthopedic follow-up care.
2. The uninsured callers had a 5.7 times higher chance of scheduling an appointment than a Medicaid caller had; uninsured callers had roughly the same odds of scheduling an appointment as a privately-insured caller.
3. However, the prices quoted to the uninsured callers were 30 percent higher than the typical negotiated rates paid by the privately-insured callers.
4. Of the practices named on Medicaid's published list of orthopedic providers accepting new patients, only three were able to schedule an appointment with the caller. Fifteen told callers they did not accept Medicaid, 11 did not treat ankle fractures and nine had incorrect phone numbers.
5. When callers who were not able to schedule appointments asked where else they could receive care, 48 percent of uninsured callers and 2 percent of Medicaid callers were directed to local public hospital emergency departments.
The researchers conclude that low appointment availability for Medicaid callers may leave patients with inadequate access to necessary follow-up care after receiving same-day orthopedic treatment.