Myths and Facts About Quality

Montana Medicaid Program: Quality and Access

Health insurance coverage is one of many factors that contribute to a person’s overall health. However, there are some common misconceptions regarding access to and the quality of care for beneficiaries of the state’s Medicaid program.

Myth: Doctors are less willing to accept Medicaid patients than privately-insured patients.

Fact: 100% of physicians employed by hospitals accept Medicaid. Additionally, all specialists holding exclusive contracts with hospitals and all physicians employed by federally qualified health clinics and other public facilities accept Medicaid. The myth stems from a 2013 survey of physicians in only 15 of the nation’s largest metropolitan cities. The study is not applicable in Montana and does not account for the state’s high acceptance rating.

Myth: Medicaid doesn’t improve overall health; beneficiaries are less healthy than privately-insured individuals.

Fact: Medicaid improves individuals’ overall health by increasing access to timely, preventive and appropriate care. Medicaid is designed to provide health insurance coverage to individuals who cannot afford private coverage.Medicaid beneficiaries are poorer and may be in poorer health than privately-insured individuals for several reasons, including environmental and social factors, food and health behaviors and demographics. Low-income adults who were previously uninsured, and who gained health insurance coverage under a state Medicaid expansion, demonstrate increased access to care and overall health care utilization.

Myth: Medicaid beneficiaries receive lower quality of care than individuals covered by private insurance.

Fact: Montana health care providers are committed to providing the highest quality care to all patients. Medicaid and privately-insured patients receive similar quality of care. A study comparing the quality of care received by nonelderly adults covered by Medicaid and private insurance found that an individual’s health behaviors – including a willingness to seek routine care and adhere to treatment recommendations – are key determinants of quality of care and health outcomes.

Myth: Being covered by private insurance is better than being covered by Medicaid.

Fact: Having health insurance is much better than being uninsured. In general, uninsured people are less healthy than those with insurance. Individuals enrolled in Medicaid are significantly more likely than the uninsured to access routine and preventive care, and significantly less likely to dismiss medical or dental care due to associated costs. Providing Medicaid to all low-income Montanans will result in a healthier and more productive population.

Myth: Medicaid beneficiaries have trouble accessing care.

Fact: Medicaid beneficiaries and the privately insured have comparable access to care. Children are similarly likely to have had a primary care visit in the past year whether they were publicly or
privately insured. Adults enrolled in Medicaid did as well as privately-insured adults on accessing a routine or specialist visit, certain cancer screenings, or obtaining a flu vaccination when health, demographic and socioeconomic differences were controlled.


Source: “What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence,” The Henry J. Kaiser Family Foundation, August 2013