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Access to Care

Doctor with child and mother. Adobe Stock

Medicaid and the Children’s Health Insurance Program (CHIP) provide critical health coverage for millions of people. Through these programs, the Centers for Medicare and Medicaid Services (CMS) supports access to care in many ways. Most importantly, people gain access to health care services that may not be affordable without Medicaid or CHIP. Additionally, some programs and benefits include special protections—such as provider network and payment methods—that help ensure services are accessible.

Preventive care and other services help people stay healthy and avoid more costly care. CMS offers materials, toolkits, and other resources for states to help Medicaid and CHIP beneficiaries learn about these services and how to access them. CMS also supports many efforts to measure access, share the results, and promote progress.


Final rule

On April 22, 2024, CMS published “Ensuring Access to Medicaid Services (CMS-2442-F)”  (Access Final Rule, CMS 2442-F), effective July 9, 2024. This final rule takes a comprehensive approach to improving access to care, quality, and health outcomes, and better addressing health equity issues in the Medicaid program across fee for service (FFS), managed care delivery systems, and in home and community-based services (HCBS) programs.  These improvements increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs, with the goal of improving access to care.

Additional information on the rule can be found in the Fact Sheet: Ensuring Access to Medicaid Services and the dates of applicability summary.

For questions about the Final Rule: