To
eliminate disparities in access to coverage, expansion programs cannot include
costly co-pays or other financial barriers to accessing care. These are especially hurtful to low-income
communities. Better options
include: raising income eligibility limits for Medicaid, expanding access to
the State Children's Health Insurance Program, and creating public/private
expansions that provide sliding-scale premium subsidies with no or limited
cost-sharing.
A "medical home," or primary care
setting where one's health care needs are looked after and care is
coordinated, is an important part of
health care access and a strategy for eliminating
disparities. Patients with a
medical home are more likely to get reminders to receive preventive care,
such as screenings for cholesterol, breast cancer, and prostate cancer.
To promote
medical homes, states need to reform primary care reimbursement by measuring
and rewarding medical homes, testing care delivery models, and maximizing the
potential of health information technology.
