Nav: Home

LSA health study documents limited access to orthopaedic care for La. Medicaid patients

August 22, 2018

New Orleans, LA - A study led by Christopher Marrero, MD, Associate Professor of Orthopaedic Surgery at LSU Health New Orleans School of Medicine, reports that despite Medicaid expansion, access to outpatient orthopaedic care in Louisiana remains significantly limited for patients with Medicaid insurance. The findings are published online as an Article in Press in the Journal of the National Medication Association, available at

"This project was done to explore how limited access to orthopaedic care is in Louisiana for Medicaid patients despite Medicaid expansion," says Dr. Marrero. "This is important because approximately one-third of the Louisiana population is enrolled in Medicaid. The limited access can and frequently does cause a delay in care, which can translate into more difficult treatments and poorer outcomes. This limited access is probably true in other specialties of medicine as well."

The research team obtained a list of potentially eligible orthopaedic surgeons in Louisiana from a public database. The study focused on orthopaedic surgeons who had received at least one Louisiana Medicaid payment from August 1, 2016 - January 31, 2017, which represented about 75% of the practicing orthopaedic surgeons in the state. The team sampled unique clinical practices rather than individual providers. They called each practice following a standard script requesting an appointment for a recommended follow-up for an orthopaedic injury treated in an Emergency Room. To avoid discrimination, the callers used generic American names. Callers made the earliest available appointment, although they cancelled before the call ended or immediately thereafter. The objectives were to secure an appointment and determine the wait time.

Sixty percent of the practices queried were private practices with only one surgeon. Twenty-six parishes had practices that qualified for the study, and of those, only 11 parishes had practices that offered an appointment. The researchers report that of the 93 practices included in the study, 17, or 18.3%, offered an appointment. Of those, 10, or 58.8%, were within a week, 2 (11.8%) were within two weeks, and 5 (29.4%) were more than two weeks from the date of the phone call. The practices that offered an appointment represented 41, or 13.3%, of the 309 orthopaedic surgeons in the study.

"Of note, 19 (46.3%) of the 41 orthopedic surgeons were LSU Health faculty practicing in the public state-funded safety-net system," Marrero adds. "Moreover, the majority of next available appointments at safety-net facilities were two weeks or more from the date of contact. If these safety-net surgeons are excluded, the percentage that offered an appointment drops to 7.1%."

The study found that Medicaid patients seeking outpatient orthopaedic care have access to only about 10% of the orthopaedic workforce in Louisiana, and 5% when safety-net facilities are excluded. The authors cite two major contributing factors - the geographic maldistribution of orthopaedic practices in Louisiana and low reimbursement. Of Louisiana's 64 parishes, only 11 have orthopaedic practices that accept Medicaid, and four of those are where LSU Health safety-net public facilities are located. Previous research suggests that increasing reimbursements may result in more Medicaid-accepting practices.

The authors conclude their results taken with those of other studies suggest that a shift in policy may be warranted.
Other members of the research team included Claudia Leonardi, PhD, Assistant Research Professor in Behavioral and Community Health Sciences at LSU Health New Orleans School of Public Health, and Linus Igbokwe at Rutgers Robert Wood Johnson Medical School.LSU Health Sciences Center New Orleans educates Louisiana's health care professionals. The state's flagship and most comprehensive health sciences university, LSU Health New Orleans includes a School of Medicine, the state's only School of Dentistry, Louisiana's only public School of Public Health, and Schools of Allied Health Professions, Nursing, and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena, the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent, advance treatment, or cure disease. To learn more, visit,, or

Louisiana State University Health Sciences Center

Related Medicaid Articles:

Kentucky study highlights harms from disruptions in children's Medicaid coverage
New research being presented at the 2017 Pediatric Academic Societies Meeting suggest that when children lose state Medicaid coverage even for a short time, they are likely to go without needed health care, or to receive care in resource-intensive setting such as emergency departments rather than less expensive primary care offices.
Study: Medicaid patients wait longer to see doctors
According to a new study by MIT researchers, Medicaid patients wait longer to see doctors than people with private health insurance.
Most new to Medicaid have no other option if Affordable Care Act repealed
Almost everyone covered through Ohio's Medicaid expansion would have no other viable insurance option should the Affordable Care Act be repealed, a new study has found.
Medicaid expansion linked with increase in prescriptions filled for chronic conditions
During the first one and a half years of the Affordable Care Act (ACA), the number of prescriptions filled by adults using Medicaid coverage increased by 19 percent in states that expanded Medicaid compared to states that did not, according to a new study from a Harvard T.H.
States with expanded Medicaid program saw higher voter turnout
In a new study, Jake Haselswerdt, assistant professor of political science and public affairs at the University of Missouri, found a correlation between voter turnout and Medicaid expansion, a key component of the ACA.
Medicaid payment reform linked to fewer early elective deliveries
It's well documented that infants born at full term have better health outcomes.
Medicaid waivers help parents of children with autism stay in the workforce
Medicaid waivers that improve access to home and community-based services for children with autism also help their parents keep their jobs, according to research from Penn State College of Medicine and collaborators.
Researchers find improved preventive care from Obamacare Medicaid expansion
More Americans are taking steps to prevent disease because of the insurance expansions of the Affordable Care Act, according to a new, groundbreaking study by Indiana University and Cornell University researchers.
Medicaid expansion linked to better care quality at health centers
In the first year of Medicaid expansion, four out of eight quality indicators at federally funded health centers improved significantly in states that expanded Medicaid compared to non-expansion states, according to a new study.
Study: Medicaid expansion boosts Michigan's economy and will more than pay for itself
Michigan's expansion of Medicaid health insurance coverage has boosted the state's economy and budget, and will continue to do so for at least the next five years, according to a new study.

Related Medicaid Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...