Medicaid enrollees report more overnight hospital stays than uninsured, privately insured

November 29, 2021 NONA TEPPER

Medicaid members were as likely as those with private coverage to have seen a general practitioner in 2019, despite being less likely to have a usual place for receiving medical services, according to a new report from the Medicaid and Children's Health Insurance Program Payment Access Commission.

Ninety percent of individuals with private coverage said they had a usual source of care, compared with 86.5% of Medicaid beneficiaries, according to MACPAC's analysis of Centers for Disease Control and Prevention survey data from 2019.

The issue brief, released this month, found that those without coverage lagged behind both groups, with 59.1% of uninsured respondents saying they had a routine source for treatment. The uninsured were more than twice as likely as those with private insurance or Medicaid to list an urgent care clinic as their normal site of service. Those without coverage also logged the same portion of overnight stays at hospitals as those with private coverage, or 6%.

UTILIZATION BY INSURANCE STATUS

Percentage of adults age 19-64 who utilized listed services in 2019 according to whether they were insured through Medicaid, private insurance or were uninsured

Medicaid enrollees were more than twice as likely to stay overnight at a hospital as those with private insurance or the uninsured. They were also significantly less likely than those with private insurance and the uninsured to report having very good or excellent health. A greater share of Medicaid enrollees also reported having chronic conditions such asthma, diabetes or heart disease than did privately insured and uninsured people.More Medicaid enrollees also self-reported suffering from chronic mental health conditions than those with private coverage or without insurance. Twenty-six percent of Medicaid respondents said they had depression and 23.6% reporting having anxiety in 2019, nearly twice the percentage for both conditions reported by the privately insured and the uninsured.

Medicaid beneficiaries also were more likely to receive care for these mental health conditions than those with and without insurance, MACPAC found.

Nearly 16% of those enrolled in the public insurance program visited a counselor in 2019, compared with 9.7% of those with private coverage.

Access to dental care represented the biggest difference between those with private insurance and those on Medicaid.

Nearly three-quarters of privately insured individuals received a dental exam in 2019, compared with 55% of Medicaid beneficiaries. MACPAC notes that not all state Medicaid programs cover dental services for adults. The panel also found that Medicaid enrollees were significantly more likely to delay or forego dental care due to cost. Twenty-nine percent put off necessary dental procedures and 26.2% of Medicaid members skipped them entirely because of cost in 2019, compared with 16.2% of privately insured people delaying and 12.4% foregoing care.