Poor health but high expectations for recipients
WASHINGTON — People on Medicaid are more prone to smoke, struggle with depression and obesity, or rate their own health as fair or poor.
But that’s not the whole story.
A new study suggests that low-income Medicaid recipients are also invested in their health, with 4 out of 5 saying they have a personal doctor, 3 out of 5 saying they eat healthy, and nearly half saying they exercise frequently.
Experts say the analysis by the Gallup-Sharecare Well-Being Index indicates that Medicaid could gain by putting more emphasis on prevention, and stressing better coordination of care. Such strategies are already employed by many workplace health plans and by Medicare.
Call it Medicaid’s health care challenge.
A federal-state program originally envisioned as a safety net for poor families and severely disabled people, Medicaid has grown to cover about 1 in 5 Americans, at a total cost of about $600 billion annually. In states that expanded Medicaid under former President Barack Obama’s health law, it has become the insurer for many low-income working adults. The Trump administration tried to unravel Obama’s expansion, but top officials have also said they want to work to better the health of Medicaid beneficiaries, not just pay medical bills.
“We now have emerging evidence in Medicare and commercial insurance of how care coordination and prevention can help patients with chronic conditions avoid costly hospitalizations and ER visits,” said Kavita Patel, a policy expert at the Brookings Institution who’s also a practicing physician. “This really should become the standard across Medicaid programs.”
In small town Stuttgart, Ark., Vickie Rose says Medicaid coverage is helping her try to quit smoking for good, which would entail shutting down a decades-long habit that once reached three packs a day.
“I’m not going to be able to stay out of hospitals if I don’t take matters into my own hands,” said Rose, who’s in her early 60s and has worked jobs from factory supervisor, to retail, to staffing an animal shelter. Sometimes she travels 20 miles to the Mid-Delta community health center in neighboring Clarendon for smoking cessation meetings.
“Instead of waiting on everyone else, this time I’m going to do it for myself,” Rose said.
Thirty-six percent of Medicaid recipients said they smoked in the Gallup-Sharecare study, compared to 13 percent of those with employer or union health insurance, and 16 percent of Medicare beneficiaries.
The Gallup-Sharecare survey interviewd about 500 people a day on health care issues. The new analysis compared health indicators among people with different types of coverage.
Because Medicaid pays less than private insurance or Medicare, a longstanding criticism is that beneficiaries might not be able to find a doctor who’ll see them. But most states now contract with private insurers to administer their programs, and those insurers must provide a physician network.