Access to Health Care for Young Rural Medicaid Beneficiaries
This study examined access to health care among rural children ages 0-17 who are enrolled in some type of Medicaid managed care program, and compared this access across types of programs and, within program type, to that of urban beneficiaries. Access to care was assessed by means of a mailed survey sent to the parents of Medicaid children in four states chosen for their geographic diversity. Questions focused on such issues as the ability to find a participating health care provider within a reasonable distance, coordination of care concerning services such as specialty care that are more likely to be located in urban areas, use of dental services, and transportation problems.
Publications
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Rural and Urban Parents Report on Access to Health Care for their Children with Medicaid Managed Care
Author(s): Victoria Freeman, Rebecca Slifkin, Asheley Skinner, Robert Schwartz
Report Number: Working Paper No. 84
Date: 12 / 2005
There has been little previous research on rural beneficiaries' perspectives on access to care under Medicaid managed care. The study reported here considers the perspective of the rural beneficiary in four states in order to broaden understanding of whether Medicaid managed care programs provide acceptable access to health care services. The study examines access to health care among rural children ages 0-17 who are enrolled in either fully capitated (New Mexico and Washington) or primary care case management (PCCM) Medicaid managed care plans (North Carolina and North Dakota), and compares this access to that of urban beneficiaries. Overall, this study finds that parents of children living in the rural areas who are enrolled in a Medicaid managed care program are almost always able to get the medical care they need. Rural children who are Medicaid enrollees have primary care providers, their parents know how to access care when needed after hours, and although rural children sometimes use the ER, they do not rely on that source of care more than urban parents do. Where barriers to medical care are reported, they are often consistent with those barriers reported for rural residents generally, and do not appear to be related to restrictions from managed care programs. Access to dental services remains a substantial problem, not just for children in rural areas, but for all Medicaid enrollees.
2004
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