The effect of insurance type on access to inguinal hernia repair under the Affordable Care Act

Surgery
Walter R HsiangKevin M Schuster

Abstract

The expansion of Medicaid under the Affordable Care Act extended coverage to any individual with an income up to 138% of the federal poverty level. Our study of surgeon practice management investigated the impact of the type of insurance on access to elective inguinal hernia repair and the disparities in access between Medicaid expansion and nonexpansion states. Practices of 240 hernia repair surgeons across 8 states were randomly selected from the American College of Surgeons Find a Surgeon Database. Investigators posed as simulated patients seeking an evaluation for an inguinal hernia. Physician offices were contacted using a standardized script on separate occasions to assess appointment success rates and waiting periods for 3 different insurance types (BlueCross, Medicaid, Medicare). Of 240 surgical practices contacted, 75.4% scheduled appointments for Medicaid patients, compared to 98.8% for Medicare patients and 98.3% for those with private insurance. In states that expanded Medicaid, fewer offices accepted Medicaid patients compared to those in nonexpanded states. No differences in wait times between expanded and nonexpanded states were observed. Surgeons in either solo practices or urban settings were less likely to acc...Continue Reading

Citations

Aug 7, 2020·Surgical Endoscopy·Brett M TracyChristopher K Senkowski
Jun 12, 2021·Clinical Orthopaedics and Related Research·Laurie C YousmanDaniel H Wiznia
Jun 29, 2021·Urology·Walter R HsiangMichael S Leapman

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