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Medicaid managed care may be short on primary care, report finds

Seattle Times/Kaiser Health News story

Using “mystery shoppers” looking for access to health care, Public Health-Seattle & King County has found troubling indications that access to primary-care providers may not be as advertised.  Doctor

About half the time, primary-care providers listed as accepting new patients on Medicaid managed-care organization websites in fact told the “shoppers” they were not accepting new Medicaid patients.

The initial survey was conducted over a 10-day period in early December. A random sample of adult primary-care providers was selected for each of the four regions of King County, and callers used the online provider directories of the five Medicaid Managed Care Organizations that serve King County.

The “shoppers” were staff of a survey consulting firm, but told the doctors’ offices they were uninsured patients in the process of deciding what kind of health insurance to get.

They then asked if the provider was accepting new patients for Medicaid (Apple Health) managed-care plans.

King County added about 80,000 new adult Medicaid clients over the past six months, surpassing the state’s 2018 enrollment target.

Two University of Washington Master in Public Health students working under the supervision of Public Health epidemiologist Eli Kern conducted a follow-up, which is just concluding.

The information, to be presented to the King County Board of Health on Thursday, is one part of an assessment of the success and the impact of the county’s effort to enroll the uninsured in health insurance, both private and public, made available through the Affordable Care Act.

Overall, more than 165,000 county residents were enrolled in health insurance during the campaign, which was fueled in part by knowledge of the county’s noteworthy income disparity.

According to Public Health, King County, among the 15 largest U.S. metropolitan areas, has the widest income disparity between those who do and don’t have health insurance. Read more.



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