Key takeaways :

• Women with Medicaid vs. commercial insurance had 44% longer wait for a new patient appointment.
• Appointment wait times were longest among the female pelvic medicine and reconstructive surgery subspecialty.

Women with Medicaid experienced significantly longer new patient wait times for obstetrics and gynecology appointments compared with those with commercial insurance, according to a national mystery caller study.

“Health care providers should be aware of potential disparities in access to care for patients with Medicaid insurance and work to reduce wait times and improve access to obstetrics and gynecology subspecialty care,” Michaele Francesco Corbisiero, MSc, MPH, MD candidate at the University of Colorado Anschutz School of Medicine, Aurora, told Healio. “More specifically, providers can take steps to reduce wait times by improving scheduling processes, increasing clinic capacity, and working with insurers to reduce administrative barriers to care.”

This national mystery caller study, published in the American Journal of Obstetrics and Gynecology, included 477 responding unique physicians from a patient-facing physician directory of physicians across the 49 states plus the District of Columbia.

Each physician was called twice. In separate phone calls in randomized order, a caller presented with Medicaid insurance or Blue Cross/Blue Shield insurance and asked for the soonest appointment available for respective medical conditions based on the physician’s subspecialty, for example, stress urinary incontinence, new-onset pelvic mass, preconceptual counseling after an autologous kidney transplant and primary infertility.

The overall mean appointment wait time was 20.3 business days. Researchers observed a significant difference in new patient appointment wait times associated with insurance type, with 44% longer wait times for Medicaid vs. commercial insurance holders (P < .001).

When adding the interaction between type of insurance and physician subspecialty, this difference was also significant (P < .01), the researchers wrote. The longest appointment wait times were observed for female pelvic medicine and reconstructive surgery (ratio = 1.69; 95% CI, 1.54-1.85), then gynecologic oncology (ratio = 1.40; 95% CI, 1.24-1.59 and reproductive endocrinology and infertility (ratio = 1.37; 95% CI, 1.18-1.60); the maternal fetal medicine subspecialty had the shortest wait times (ratio = 1.10; 95% CI, 0.98-1.24). Women with Medicaid insurance who required female pelvic medicine and reconstructive surgery experienced longer wait times compared with patients with commercial insurance. Those who sought care in maternal-fetal medicine experienced the least difference in wait times; however, patients with Medicaid insurance still experienced longer wait times compared with commercial insurance holders.

According to Corbisiero, understanding and addressing these disparities in access to care is critical to improve health outcomes and achieve health equity for all patients.

“Further research is needed to assess the reasons behind these disparities in access to care, which may inform strategies to reduce wait times and improve access for all patients, regardless of insurance type,” Corbisiero said. “Additionally, future studies should explore how these disparities affect Black, Indigenous, and people of color communities, who may be disproportionately impacted by barriers to care.”

For more information:

Michaele Francesco Corbisiero, MSc, MPH, can be reached at michaelefrancesco.corbisiero@cuanschutz.edu.