MSU survey to explore medical access for Medicaid patients

Contact: Maridith Geuder

As a medical sociologist working at Mississippi State, Jeralynn S. Cossman has long been aware that Mississippi is a national leader for enrollment rates in the federal Medicaid program.

With a $53,500 grant from the Robert Wood Johnson Foundation, she's about to launch a university study to determine whether state Medicaid recipients have the same access to physicians and quality healthcare as private patients.

The one-year research award is provided through the New Jersey-based philanthropy's 21st Century Challenge Fund and its Southern Rural Access Program that explores medical access for Medicaid patients. The access program is a long-term effort aimed at improving access to healthcare in Mississippi and seven other underserved rural areas, including Alabama, Arkansas, Georgia, Louisiana, South Carolina, East Texas, and West Virginia.

A research fellow at MSU's Social Science Research Center, Cossman will conduct her study under the auspices of the Mississippi Health Policy Research Center, a SSRC unit.

Arthur G. Cosby, SSRC director and policy center head, will work with Cossman to analyze data both from the state Medicaid program and Mississippi State Board of Medical Licensure. Their goal will be the creation of an objective snapshot of county Medicaid enrollment rates, state Medicaid program providers and physician-patient ratios for the general, as well as Medicaid, populations.

"Federal guidelines say that Medicaid patients should have the same access as private patients," Cossman said. "However, there have been several major changes in recent years that may impact actual accessibility."

Among those are reductions in the federal reimbursement rate to healthcare providers and a hostile tort reform climate in Mississippi. "Some research also suggests that physicians believe Medicaid patients have more medically complicated conditions and a greater propensity to sue," Crossman explained.

Combined with other factors--the rural nature of the state and the numbers of retiring and relocating Mississippi physicians--there is the potential for what Cossman describes as "a crisis in healthcare access in Mississippi."

As the research team begins to analyze data early next year, Cossman plans to begin developing health maps.

"The maps would show the drive time required for Medicaid and non-Medicaid patients to reach a physician," she said. "Comparison of the two will indicate whether there is comparable physical access to physicians in Mississippi for both populations."

In addition, the research will help determine how reimbursement rates have affected access by Medicaid patients both to general physicians and to specialists; and how physician participation in Medicaid has been impacted by reimbursement changes and the state's legal climate.

Cossman said the results will be shared with state policymakers, medical associations, hospital groups, and others as background for planning and evaluation. "This project is of utmost importance for informing policies related to Medicaid, the impact of current health policies and the development of new health care programs," she added.

The MSU-based Mississippi Health Policy Research Center is funded by the Bower Foundation of Jackson and focuses on issues of health in Mississippi.

The Robert Wood Johnson Foundation is the nation's largest philanthropy devoted exclusively to healthcare. It regularly awards grants in four primary areas: basic healthcare at a reasonable cost; improve care and support for people with chronic health conditions; promotion of healthy communities and lifestyles; and reduction of personal, social and economic harm caused by substance abuse.

For more information about the study, telephone Cossman at (662) 325-7880.