Hospital wait times longer for Medicaid patients than privately insured, Health Affairs study finds

Long hospital wait times aren't a pervasive problem among the general population, but the picture is slightly worse for Medicaid patients, who typically have longer wait times than those with private insurance, according to a new study published in Health Affairs.

In fact, Medicaid patients were 20 percent more likely than privately insured patients to wait 20 minutes or longer.

By analyzing data on 21 million outpatient visits obtained from electronic health records, the research found that the median wait time for Medicaid patients was 4.6 minutes past their scheduled appointment time, compared to 4,1 minutes for the privately insured. Moreover, 18 percent of visits for Medicaid patients has a wait time of more than 20 minutes, compared to 16.3 percent for privately insured patients.

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Medicare patients, by contrast, had shorter median wait times than the privately insured, but had a greater share of visits with long wait times, largely explained by the age distribution of Medicare patients, who skew older and are generally more punctual. Visits by self-paying patients had the longest wait times.

The findings are significant because hospital wait times often influence patients' perceptions of their overall experience, and could affect the scores a hospital receives on the Hospital Consumer Assessment of Healthcare Providers and Systems, the patient satisfaction survey required by the Centers for Medicare and Medicaid Services.

Even among visits to the same practice and physician, Medicaid patients were 6 percent more likely to wait 20 minutes or longer.

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The study suggests that practices and physicians that disproportionately serve Medicaid patients differ in other aspects of care -- including differences in practice location, per capita income and urban status, as well as physician characteristics such as medical school attended, number of years in practice and the probability of being board certified.

Medicaid patients were also found to wait longer than privately insured patients in states with less generous Medicaid reimbursement rates. This may be because, in higher-reimbursement states, Medicaid patients have more access to high-quality practices and providers. This comports with other findings showing a positive correlation between higher reimbursement and physicians' willingness to accept Medicaid patients.

Wait time differences between Medicaid patients and the privately insured were not affected by differences in the health of those groups.

Twitter: @JELagasse