Case Study: Medicaid Vs. Private Insurance

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Table 2 shows that many more adolescents with SCD are enrolled in Medicaid than private insurance plans (Amendah, 2010). Nationwide, nearly 70% of SCD pediatric patients are on Medicaid and not privately insured (Steiner, 2006). Ellison and Bauchner (2007) note that SES as measured by insurance is associated with more frequent hospital visits and longer length of stay in the hospital. In a recent study, Matthie et al (2015) found income to be the factor most significantly and negatively associated with hospital visits for SCD. They observed that as income increases, the number of hospital visits for pain crises is likely to decrease because individuals with better health insurance can obtain superior primary care, and thus may experience fewer …show more content…
$14,772, respectively. In a report published one year later, Amendah et al (2010) estimated that medical costs for children due to SCD were $9,369 and $13,469 for Medicaid vs. private insurance, respectively. Though the numbers lowered in the second report, the margins at which each shared the cost were nearly the same. Reinhardt (2006) offers an explanation for the disparity, noting that the lower expenditures actually reflect lower payments or reimbursements by Medicaid programs to providers and cost shifting to other payers. Notably, both reports found that Medicaid patients had higher utilization of the emergency room in accordance with the Ellison and Matthie studies, even though they had lower …show more content…
In 2003, of the 20,000 hospitalizations for children with SCD, over 16,000 of them were for vaso-occlusive painful events (Whalen, 2006). Pain episodes often require medications such as opioids for pain relief. Because they are prescribed pain medications from a very young age, Wilson et al (2015) note that many SCD patients are perceived as drug seekers once they enter the emergency department due to assumed addiction. In a study conducted by Porter et al (2012), they found that 63% of nurses working with pediatric patients believed addiction was a factor, and 30% were reluctant to administer a high dose of pain
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