Joanna Bisgaier|Karin V. Rhodes
Auditing Access to Specialty Care for Children with Public Insurance
health care reform expanded eligibility public insurance without fully addressing concerns access measured childrens access outpatient specialty care identify disparities providers acceptance medicaid childrens health insurance program chip versus private insurancebetween january may 2010 research assistants called stratified random sample clinics representing eight specialties cook county illinois high proportion specialists callers posed mothers pediatric patients common health conditions requiring outpatient specialty care two calls separated 1 month placed clinic person use standardized clinical script differed insurance statuswe completed 546 paired calls 273 specialty clinics found significant disparities provider acceptance medicaidchip versus private insurance across tested specialties overall 66 medicaidchip callers 179 273 denied appointment compared 11 privately insured callers 29 273 relative risk 62 95 confidence interval ci 43 88 p0001 among 89 clinics accepted insurance types average wait time medicaidchip enrollees 22 days longer privately insured children 95 ci 68 375 p0005we found disparity access outpatient specialty care children public insurance private insurance policy interventions encourage providers accept patients public insurance needed improve access care