Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act.
Background: Millions of adults have gained insurance through the Affordable Care Act (ACA). However, disparities in access to care persist.Objective: This study examined differences in access to primary and specialty care among patients insured by private individual market insurance plans (both on-e...
| Publicado en: | Medical Care Vol. 56; no. 2; pp. 186 - 193 |
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| Autores principales: | , , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Feb2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=128141358&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 128141358 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: Feb2018 vid: 56 iid: 2 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 128141358 128141358 NLM29271819 10.1097/MLR.0000000000000855 NLM29271819 128141358 ppf: 186 ppct: 7 formats: tig: atl: Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act. aug: au: Alcalá, Héctor E. Roby, Dylan H. Grande, David T. McKenna, Ryan M. Ortega, Alexander N. affil: Department of Family, Population and Preventative Medicine, Stony Brook University, Stony Brook, NY. sug: subj: Patient Protection and Affordable Care Act Standards Primary Health Care Administration Health Insurance Exchanges Statistics and Numerical Data Health Services Accessibility Statistics and Numerical Data Insurance Coverage Statistics and Numerical Data Adult United States California Medicaid Statistics and Numerical Data Appointments and Schedules Male Female Clinical Assessment Tools Adult: 19-44 years Male Female ab: Background: Millions of adults have gained insurance through the Affordable Care Act (ACA). However, disparities in access to care persist.Objective: This study examined differences in access to primary and specialty care among patients insured by private individual market insurance plans (both on-exchange and off-exchange) and Medicaid compared with those with employer-sponsored insurance.Research Design: Using data from the 2014 and 2015 California Health Interview Survey, logistic regression analyses were used to calculate the odds of being unable to access primary care providers, access specialty care providers and receive a needed doctor's appointment in a timely manner, with insurance type serving as the independent variable. Interaction terms examined if the expiration of the ACA's optional Medicaid primary care fee increase in 2014 modified any of these associations.Results: Findings showed poorer access to providers among those insured through Medicaid and the individual market (whether purchased through the state's health insurance exchange or off-exchange) relative to employer-based insurance. Poor access to primary care providers was seen among private coverage purchased via exchanges, relative to private coverage purchased on the individual market. In addition, findings showed that reduction of Medicaid fees coincided with reduced ability to see primary care providers. However, a similar trend was seen among those with employer-based coverage, which suggests that this change may not be attributable to reductions in Medicaid fees.Conclusion: Despite ACA-related gains in insurance coverage, those with on-exchange and off-exchange individual private insurance plans and Medicaid encounter more barriers to care than those with employer-based insurance. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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