Reading level of Medicaid renewal applications often too high

VANCOUVER, BRITISH COLUMBIA — Simplifying Medicaid renewal applications may help families keep their children enrolled in the government health insurance program, resulting in better medical care, according to research to be presented Saturday, May 1 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Many studies have shown that literacy-related barriers affect retention in the Medicaid program. This study compared the reading level of the Medicaid renewal applications in all 50 states and looked at the effect of reading level on child retention.

Results showed that 92 percent of applications were written at or above the fifth-grade reading level. In addition, 46 states had reading level guidelines for Medicaid information, but 46 percent of these states failed to meet their own guidelines.

Researchers also found that the risk of a child getting dropped from coverage went up significantly with each grade level increase in the language used in the Medicaid renewal application.

Given that 90 million American adults have inadequate health literacy — 40 million of whom read below a fifth-grade reading level — it is likely that many caregivers of children enrolled in Medicaid have difficulty completing renewal applications, the researchers noted. This inability to fill out the forms may explain, in part, the brief (usually one to three months) lapses in insurance coverage that are common among Medicaid-eligible children. These gaps have been associated with delays in obtaining medical care, including missed preventive visits and unfilled prescriptions.

“This finding is troubling because studies have shown even small gaps in Medicaid coverage may lead to delayed access to health care for children,” said Susmita Pati, MD, MPH., lead author of the study and a pediatric researcher at The Children’s Hospital of Philadelphia. “This study shows that the literacy level of the applications is one factor that contributes to a child getting dropped from coverage and, in turn, to poor outcomes.”

To improve child Medicaid retention, efforts to simplify renewal applications merit serious consideration, the authors concluded.

To see the abstract, go to http://www.abstracts2view.com/pas/view.php?nu=PAS10L1_3986&terms

The Pediatric Academic Societies (PAS) are four individual pediatric organizations who co-sponsor the PAS Annual Meeting — the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. Members of these organizations are pediatricians and other health care providers who are practicing in the research, academic and clinical arenas. The four sponsoring organizations are leaders in the advancement of pediatric research and child advocacy within pediatrics, and all share a common mission of fostering the health and well being of children worldwide. For more information, visit www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.


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