The Commonwealth Fund Biennial Health Insurance Survey , 2014, explores the experiences of adults with private insurance and Medicaid beneficiaries who had coverage for a full year, as well as adults who were uninsured for some time during the year. The survey asked individuals about the quality of health care they received, access to preventive health services, responsiveness of health care providers, and about cost-related experiences. The survey found:
- On Access to Care
- Medicaid beneficiaries were as likely as those with private insurance, and significantly more likely than uninsured adults, to report having a regular source of care.
- Adults with Medicaid who were covered all year reported getting recommended preventive care services -- like blood pressure and cholesterol checks, and seasonal flu shots -- at higher rates than did adults who were uninsured part of the year.
- On Quality of Care
- Medicaid beneficiaries rated the quality of their care as highly as privately insured adults, and significantly better than uninsured adults.
- Adults with private insurance or Medicaid reported at higher rates than did those who were uninsured that their doctor always or often knows their medical history.
- On Cost-Related Issues
- Adults with Medicaid were significantly less likely than either privately insured or uninsured individuals to report difficulty paying medical bills, being contacted by a collection agency about unpaid bills, having to change their way of life to pay medical bills, or paying off medical bills over time.
- Those with Medicaid were also significantly less likely to report skipping services because of the cost of care compared with adults who had spent time uninsured.
In some cases, adults with Medicaid coverage and those with private insurance had significantly different experiences when it came to cost-related problems associated with obtaining care. For example, privately insured adults reported skipping a recommended medical treatment, test, or follow-up visit because of cost at more than twice the rates reported by adults with Medicaid (18% vs. 7%).
Although Medicaid coverage is widely believed to afford poor access to specialists (because Medicaid’s provider payment rates tend to be lower than private plan reimbursement), Medicaid enrollees were less likely than privately insured adults to report that cost was a reason not to pursue specialty care (5% vs. 11%).
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