Download

Download Full Text (548 KB)

Description

Access to healthcare significantly varies by medical insurance type, particularly for individuals for low socioeconomic status.

• Medicaid often covers these individuals (a government-funded program for low-income adults and children).

• Only 45% of primary care providers accept new Medicaid patients, versus 94% for private insurance.1

• Large non-profit medical centers accept Medicaid but still present considerable access challenges for patients.

• Lower reimbursement rates, complex medical needs, and extensive administrative requirements are key barriers for providers accepting Medicaid.

• Studies, such as those by Deans et al., highlight greater travel burdens for Medicaid patients needing revision hip or knee arthroplasty.2

• Medicaid patients often receive care in facilities where surgeries are performed less frequently, correlating with poorer outcomes.3

• Medicare primarily serves the over-65 demographic, those with disabilities, and end-stage renal disease patients à a significant portion of orthopedic cases

• Better access than Medicaid but challenged by declining reimbursements.

Purpose

• To elucidate the impact of insurance type—Medicaid, Medicare, and private insurance—on short-term outcomes, complications, and patient reported outcomes (PRO’s) following total joint arthroplasty over a tenyear period.

Hypothesis • Individuals with Medicaid or Medicare are hypothesized to experience higher complication rates and inferior PROs compared to those with private insurance

Publication Date

5-2025

Keywords

medical insurance, Medicaid

Disciplines

Orthopedics

Comments

The Embark Capstone Colloquium at the Oakland University William Beaumont School of Medicine, Rochester Hills, MI, May, 2025.

Influence of Medicaid and Medicare on Total Joint Arthroplasty Outcomes: 10-year Report of Michigan Hospitals

Included in

Orthopedics Commons

Share

COinS