Comparison of Patient Experiences in Medicaid and Commercial Health Plans

Providing a good quality care for Medicaid patients has been a persistent challenge. To evaluate quality of care provided by Medicaid plans in comparison with that of commercial plans, this study used the CAHPS (Consumer Assessment of Health Plan Study) survey, which measured the experiences of patients using frequency report instead of traditional satisfaction measures that are more vulnerable to a response bias. This study found that Medicaid managed care services for children has not yet achieved the goals of providing access to and quality of care equivalent to that of commercial insurance. This study also confirmed potential problems in relying entirely on global ratings or satisfaction measures in assessing quality of care. While global ratings of Medicaid care were as good as and sometimes better than commercial counterparts, Medicaid patients reported worse access to necessary care. Based on the results, implications were drawn for future efforts in assessment and improvement of quality of care for Medicaid patients.