Barriers to Accessible Health Care for Medicaid Eligible People With Disabilities

Abstract

People with disabilities (PWD) are more likely than those without disabilities to experience barriers when accessing healthcare, often leading to unmet needs. The chasm between what providers perceive as adequate care for PWD and the actual health care needs as perceived by PWD remains significant. Using data from 360 health care providers and 540 Medicaid eligible PWD, we compared perceived barriers to care faced by PWD from the perspective of both providers and PWD. Our results indicated major variations in provider and PWD perceptions about barriers to care. PWD and providers both perceived transportation issues as the highest ranked barriers and physical access issues as the lowest ranked barriers. Multivariate results indicated that PWD reported barriers when communicating with providers, although providers did not consider communication as a major barrier. Among PWD, those with multiple types of disabilities were more likely to experience barriers when communicating with providers compared with other PWD. In addition, providers considered insurance a barrier to care, although this was not the perception of PWD. Particularly in the era of health care reform, policy responses to these findings should address the specific needs of people with different types of disabling conditions rather than assuming all PWD face similar challenges in accessing and utilizing health care.