Survey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act.
Foot Ankle Int
; 37(7): 776-81, 2016 Jul.
Article
em En
| MEDLINE
| ID: mdl-27026727
ABSTRACT
BACKGROUND:
The purpose of this study was to assess the effect of insurance type (Medicaid, Medicare, and private insurance) on access to foot and ankle surgeons for total ankle arthroplasty.METHODS:
We called 240 foot and ankle surgeons who performed total ankle arthroplasty in 8 representative states (California, Massachusetts, Ohio, New York, Florida, Georgia, Texas, and North Carolina). The caller requested an appointment for a fictitious patient to be evaluated for a total ankle arthroplasty. Each office was called 3 times to assess the responses for Medicaid, Medicare, and BlueCross. From each call, we recorded appointment success or failure and any barriers to an appointment, such as need for a referral.RESULTS:
Patients with Medicaid were less likely to receive an appointment compared to patients with Medicare (19.8% vs 92.0%, P < .0001) or BlueCross (19.8% vs 90.4%, P < .0001) and experienced more requests for referrals compared to patients with Medicare (41.9% vs 1.6%, P < .0001) or BlueCross (41.9% vs 4%, P < .0001). Waiting periods were longer for patients with Medicaid compared to those with Medicare (22.6 days vs 11.7 days, P = .004) or BlueCross (22.6 days vs 10.7 days, P = .001). Reimbursement rates did not correlate with appointment success rate or waiting period.CONCLUSION:
Despite the passage of the PPACA, patients with Medicaid continue to have difficulty finding a surgeon who will provide care, increased need for a primary care referral, and longer waiting periods for appointments. LEVEL OF EVIDENCE Level II, prognostic study.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Artroplastia
/
Cobertura do Seguro
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Patient Protection and Affordable Care Act
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Acessibilidade aos Serviços de Saúde
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Articulação do Tornozelo
Tipo de estudo:
Prognostic_studies
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article