• The NEJM Medicaid audit study

    Today’s health research buzz is about the NEJM Medicaid audit study (ungated). If you want some intelligent takes on it, read Harold Pollack and Bill Gardner. Here are a few points on my mind, some of which Harold or Bill may have made:

    1. Finding that some proportion of doctors doesn’t accept one type of insurance is not the same thing as finding a disparity in health outcomes caused by differences in access.
    2. Private plans have networks. Some are broad and some are more narrow. The study compared Medicaid to a plan with a very broad network, BCBS. By the study’s methods, individuals in plans with more narrow networks would have less access than BCBS enrollees. Do we think differently about those plans than about Medicaid? Why or why not?
    3. The study findings can be used in two different ways. We’ll probably see some say that it shows Medicaid needs to be better funded. We’ll probably see some others say that it shows that Medicaid is fatally flawed. A few people may say both.
    4. Related work has been done by Asplin, et al. (ungated and about which I once blogged) and also by Galbraith and colleagues.

     

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    • “Private plans have networks. Some are broad and some are more narrow. The study compared Medicaid to a plan with a very broad network, BCBS. By the study’s methods, individuals in plans with more narrow networks would have less access than BCBS enrollees. Do we think differently about those plans than about Medicaid? Why or why not?”

      It’s a good point; has anyone done that study? It ought not to be that difficult.