The Hill

Pediatric Health Care Is Difficult To Access In Some States; Analysis Reveals Gaps For Publicly Insured Kids

Pediatric Health Care
Access to health care varies widely among private and public insurers. Photo courtesy of Shutterstock

Covering costs isn’t the only hurdle people face when it comes to securing health care for children in the United States. Accessibility and availability can be the difference between a child receiving quality care and/or being neglected of necessary treatment.

A team of statisticians recently compared pediatric care across the country and revealed the different problems in seven major states: California, Georgia, Louisiana, Minnesota, Mississippi, North Carolina, and Tennessee. The findings, presented at the 2015 Joint Statistical Meeting on Monday, not only highlighted these disparities, but also ranked states based on the level of improvement and intervention they needed to improve health care issues. The analysis serves as a microcosmic example of how today's pediatric health care providers vary in accessibility throughout America.

Researchers argue there's a need to push for improvements beyond the Patient Protection and Affordable Care Act. It's not enough to be able to pay for health care, said analysis’ statistician Nicoleta Serban, a statistics professor at Georgia Tech, but "health care services also need to be accessible within reasonable travel time and available with reasonable wait times."

Serban and her team looked at more than nine million children living in selected states based on how accessible pediatric primary care services were to them. Accessibility was determined by the distance and time it would take for patients to reach their health care provider — more than 20,000 locations were considered.

The seven states were chosen because of their variety in size and demographics. Each state also implemented Medicaid and the Children’s Health Insurance Program (CHIP) differently, both federally funded programs to help low-income families cover health care costs for their children.

In terms of distance, California and Minnesota pediatric providers were the most accessible to publicly insured patients, while North Carolina, Tennessee, and Minnesota were the least accessible to privately insured patients.

Mississippi had longer wait times for publicly insured patients than all other states, while Minnesota and Louisiana had the shortest wait time for publicly insured patients. Louisiana also had the shortest wait times for privately insured patients, as did Tennessee.

Overall, children who were publicly insured by Medicaid and CHIP had less access to their pediatrician than children who were privately insured. California is currently poised to benefit the most from improved health care access as most of its communities have to travel two miles further than communities home to privately insured children do. By decreasing the distance publicly insured patients have to travel to receive care, it stands to reason California’s pediatric care would become more accessible.

With pediatric providers already within distance, it’s just a matter of incentivizing providers to accept pubic insurance. One incentive may be to negotiate a higher reimbursement rate or tax credit from the government.

The analysis is one part of Healthy People 2020, a 10-year-long national initiative to improve health promotion and disease prevention across all age groups. Since the initiative launched December 2010, researchers have worked to identify disparities with the hope of influencing future policy. 

"We believe policymakers at both the federal and state levels can use this study's findings to enact targeted policies that will address the care accessibility and availability disparities we have identified," Serban said. "The study highlights which geographic areas are in need of improvements to pediatric primary care access for not only publicly insured children, but also privately insured children living in communities with little access to such care."

Source: Serban N, Gentili M, and Swann J. Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care with Implications for Policy Making. 2015 Joint Statistical Meetings.

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