title: Do patients with income-based insurance have access to total joint arthroplasty?
abstract: The Patient Protection and Affordable Care Act (PPACA) is expected to increase health care availability through Medicaid expansion. The objective of this study was to evaluate potential effects of the PPACA by examining access to total hip arthroplasty in Southern California. 39 orthopaedic surgeons were called to schedule a hip arthroplasty. Insurances used included a Preferred Provider Organization (PPO), Medicare, and three income-based insurances. There was a significant difference in acceptance rate when comparing PPO and Medicare patients with income-based insurances (P < 0.001). This study showed that in Southern California, patients with income-based insurances are limited in the number of surgeons from whom they can receive care. Thus, although the PPACA will increase the number of insured patients, it may not similarly increase access to providers.
authors.affiliation: Department of Orthopaedic Surgery, University of California Irvine, Orange, California.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
authors.affiliation: Department of Orthopaedic Surgery, University of California Irvine, Orange, California.
authors.forename: Duy L
authors.initials: DL
authors.lastname: Phan
authors.affiliation: Department of Orthopaedic Surgery, University of California Irvine, Orange, California.
authors.forename: Melinda
authors.initials: M
authors.lastname: Hoang
authors.affiliation: Department of Orthopaedic Surgery, University of California Irvine, Orange, California.
authors.forename: Steven D K
authors.initials: SD
authors.lastname: Ross
authors.affiliation: Health Policy Research Institute, University of California Irvine, Irvine, California.
authors.forename: Dana
authors.initials: D
authors.lastname: Mukamel
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Medicaid; Patient Protection and Affordable Care Act; health care access; income-based insurance; total hip arthroplasty