Access to primary and specialty care and emergency department utilization of medicaid enrollees needing specialty care

Abstract

Objective: Medicaid enrollees are more likely to use the emergency department (ED) than the privately insured and uninsured, yet little is known about enrollees' problems in accessing primary care and specialty care providers among those needing specialty care.

Data sources: The study sample is from the 2003-2010 Medical Expenditure Panel Survey (MEPS) of 2,733 Medicaid enrollees reporting a need for specialty care.

Methods: This paper estimates a two-part model to analyze the relationship between enrollees' access to providers and ED visits.

Principal findings: Perceived problems accessing a primary care physician are associated with ED use among Medicaid enrollees. Despite reporting need and facing barriers, access to specialty care is not significantly related to ED use.

Conclusions: As states prepare for the impending expansion of Medicaid funded via the Affordable Care Act, they should address barriers to accessing primary care providers for Medicaid enrollees with high need.