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FEDERAL LEGISLATION NEWS-Report indicates Medicaid beneficiaries with chronic illness have better access to care than uninsured counterparts

By Danielle H. Capilla, JD

A report on the role of Medicaid for adults with chronic illness, looking at data on spending, utilization, and access to care, was published by the Kaiser Commission on Medicaid and the Uninsured. According to the report, Medicaid beneficiaries with chronic illness reported better access to care then their uninsured counterparts, which could aid policymakers in designing programs to meet the needs of Medicaid enrollees. This information should be utilized in decisions related to benefit design, delivery systems and provider networks as Medicaid coverage is expanded to more individuals due to the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-158).

The report looked at Medicaid's role for individuals with chronic illness including diabetes, cardiovascular disease, respiratory disease and mental illness. One in ten Medicaid beneficiaries suffered from a diabetes diagnosis and 28 percent were diagnosed with cardiovascular disease while 35 percent were diagnosed with a mental illness. These diagnoses were higher among Medicaid beneficiaries than the uninsured, which was explained as being the result of Medicaid rules that extend program eligibility to people who are medically needy. Despite the higher rates, there are still notably high levels of chronic illness among the uninsured, with up to 13 percent of the uninsured suffering from mental illness. The possibility remains that some uninsured individuals remain undiagnosed with chronic illness due to lack of care.

Because Medicaid meets the needs of a high use population, including beneficiaries with complex comorbid conditions, as enrollment expands due to PPACA, the report notes that it will be critical for states to ensure adequate provider capacity so that new enrollees have access to care. The results indicate that new enrollees will be able to better manage chronic conditions, as long as access to primary care, preventative and specialized care remains available.

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