Medicaid Data: Is It Any of Your Business?

This is from Jim Frogue's testimony to the House Energy and Commerce Committee.

Medicaid patient encounter data is sometimes available to researchers, but not to the general public.  That's too bad.  Taxpayers should know where their money goes.  In one state:

  • Only 17% of Medicaid women over age 50 were given an annual mammogram. (Many doctors think the number should be 100%)
  • Less than half the children received well child checkups.
  • One beneficiary visited hospital emergency rooms 405 times in three years-more than once every three days.

Comments (2)

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  1. NurseKeith says:

    I think this is absolutely our business, and these numbers are distressing indeed. And how does that data extrapolate across the country?

    What are the reasons for such poor data? Are doctors who see Medicaid patients reimbursed too little for their visits, causing them to rush past important health maintenance issues in order to see more patients per day? Do patients with Medicaid receive less complete care than those with private insurance? Do these numbers coincide with patients who do have private insurance?

    As a former Nurse Care Manager for chronically ill patients on Medicaid in the inner city, we saw how many of our patients were frequent flyers in the ER, ballooning costs unnecessarily for issues that could have been addressed in primary care if the patients had actually shown up at appointments.

    This is a multifactorial problem with few ready answers. However, it is frustrating to know how our tax dollars are so often squandered.

  2. hina mir says:

    hi friends i have a question i am pregnent and i dont have ssn or medical insurance. so what should i do i have already apply for medicaid. but i am cunfused what do they ask from me.