Sunday, January 31, 2010

Access to preventive care for children

Is the Medicaid safety net strong enough to care for America's neediest children? Despite that many believe Medicaid to be a "ghetto" for healthcare, it does not necessarily provide less effective coverage for children, as a recent excellent article in American Medical News explains:
According to the 2007 National Survey of Children's Health. Based on nearly 92,000 interviews, it found that in 36 states, children in Medicaid and CHIP were as likely or more likely than privately insured kids to have had at least one preventive health care visit over a 12-month period.

"That's what I would expect," said Jay E. Berkelhamer, MD, past president of the American Academy of Pediatrics. Medicaid's advantage lies in the fact that the federal government requires it to cover a standardized package of preventive care benefits for children called the Early Periodic Screening, Diagnosis, and Treatment program. It includes immunizations and dental, vision and hearing screenings. By contrast, private insurance coverage for children is "all over the map," Dr. Berkelhamer said.

But regardless of how strong it is now, some lawmakers and governors have said the public safety net would stretch too thin if the program were expanded to cover millions more people, because states can't afford it. And counting on states to help foot the bill would force them to cut other spending, such as for education, Sen. Orrin Hatch (R, Utah) said late last year. "The last thing we need right now is for Washington to impose more liability on the states."
There is also the issue of reimbursement. Medicaid pay was 72% of Medicare rates and 66% of primary care rates in 2008. This can create a significant burden on a practice that has a high ratio of Medicaid patients.

Children enrolled in Medicaid and the Children's Health Insurance Program in 2007 were less likely than privately insured kids to have a medical home or access to specialists or mental health care. When it came to accessing preventive care, however, publicly insured children did slightly better than those with private coverage.

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Source: Child and Adolescent Health Measurement Initiative, 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health (


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