Urban Institute study finds doctors order fewer preventive services for women on Medicaid vs. private coverage

July 01, 2015

Gynecologists ordered fewer preventive services for women who were insured by Medicaid than for those with private coverage, a study found. Researchers at the Urban Institute examined how office-based primary care practices provided five recommended preventive services - clinical breast exams, pelvic exams, mammograms, Pap tests and depression screening - over a five-year period. Overall, 26% of the visits by women with Medicaid included at least one of the five services, compared with 31% of the visits by privately insured women. As for specific preventive services, the study found "strong evidence" that visits by Medicaid patients were less likely include a clinical breast exam or a Pap test, says the study's lead author. For example, 20.5% of visits by privately insured women included a clinical breast exam, and 16.5% of visits included a Pap test. The percentage of Medicaid-insured visits that included those services was only 12% and 9.5%, respectively.