Health and Disability

One of the first studies of its kind, released today as a Web First by Health Affairs, examined the length of time new beneficiaries had to wait for primary care appointments in Michigan, a state that expanded eligibility for Medicaid in 2014. The study, by Renuka Tipirneni, Karin Rhodes, Rodney Hayward, Richard Lichtenstein, Elyse Reamer, and Matthew Davis, found that appointment availability increased 6 percentage points for new Medicaid patients and decreased 2 percentage points for new privately insured patients, compared to availability before expansion.

The study was modeled after the simulated patient study (or “secret shopper”) approach recommended by the Department of Health and Human Services (HHS) to examine access to care for new Medicaid patients. Research team members, posing as new patients, called a random sample of approximately 300 primary care practices around the state before and after Michigan’s April 1, 2014, expansion of Medicaid.

“It is noteworthy that Medicaid appointment availability in Michigan increased rather than decreased during a period when approximately 350,000 adults entered the Medicaid system and the number of primary care providers likely remained stable,” concluded the authors. They noted that it was not possible to conclude from this study if new patients with private insurance were being displaced by those with Medicaid, and called for further research to determine “whether increased access to care will persist in Michigan, and whether access to primary care for new patients with Medicaid in other states will follow similar patterns.”