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Medicare/Payer/Legislation

Is It More Difficult for Medicaid Patients to Get an Eye Appointment?

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Do patients who receive Medicaid have a more difficult time accessing eye care appointments than those with private insurance? A recent prospective, cohort study suggests so. 

Investigators randomly telephoned ophthalmologists and optometrists in 2 states to request an appointment. They requested either an appointment for a diabetic eye exam or a routine child eye exam. Each practice was called twice, once requesting an appointment for a patient with Medicaid, and once for a person with private insurance. Researchers tracked the rate of successful appointments, as well as wait time. Among the results: 

  • 62% of Medicaid callers were able to get a diabetic eye exam, vs 79% of those with private insurance. 
  • These rates for a child eye exam were 45% and 63%, respectively. 
  • Average wait times were similar in both groups for both adults and children. 
  • Odds of obtaining an appointment for a diabetic eye exam were nearly two times higher when calling an optometrist vs an ophthalmologist.
  • They were 8 times higher when making an appointment for a child eye exam with an optometrist vs an ophthalmologist. 

Lee Y, Chen A, Varadaraj V, et al.  Comparison of access to eye care appointments between patients with Medicaid and those with private health care insurance. JAMA Ophthalmol. 2018;136(6):622-629. doi: 10.1001/jamaophthalmol.2018.0813.    

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