A new study found children with public insurance are slightly more likely to receive unnecessary medical services than those with private insurance. One in nine publicly insured and one in 11 privately insured children received low-value care in 2014, according to the findings published in journal Pediatrics.
For the study, researchers at the University of Michigan, evaluated data for 8.6 million children in 12 states to see whether having public or private insurance is associated with receiving low-value medical services. Data analyzed included 2013–2014 Medicaid Analytic eXtract and IBM MarketScan Commercial Claims and Encounters databases. Researchers used 20 measures of low-value care – 6 diagnostic testing measures, 5 imaging measures, and 9 prescription drug measure. Among publicly and privately insured children in the sample, respectively, 11% and 9% received unnecessary services at least once in 2014 while about 4% and 3% received low-value services at least twice. About 1 in 33 publicly and privately insured kids received a low-value diagnostic test at least once in 2014. About 1 in 12 publicly insured and 1 in 20 privately insured children received a low-value prescription drug at least once.
While publicly insured children were slightly more likely to receive low-value services, the difference was not large. The study shows that insurance type does not strongly predict whether a child is likely to receive wasteful care.
- Michigan Medicine, University of Michhigan: Children Frequently Receive Unnecessary Medical Care Regardless of Insurance Type, Jan 7 2020.
- Differences in the Receipt of Low-Value Services Between Publicly and Privately Insured Children. Pediatrics, January 2020