Advancing Patient and Family-Centered Care

For America’s poorest children, Medicaid is a critical health safety net. Yet in some states, Medicaid reimbursement is so low and its administrative requirements so cumbersome, that many providers refuse to accept it, effectively blocking access to care for the most vulnerable children.

In a recent class action lawsuit filed on behalf of pediatric Medicaid recipients against the state of Illinois, the judge ruled that the state was in violation of the Medicaid legislation’s “Equal Access Provision,” which requires that access for Medicaid-enrollees be equal to that of their privately-insured counterparts. Consequently, the state was required to increase Medicaid reimbursement rates for primary care services and reduce its administrative burden.

For her dissertation, PhD candidate Joanna Bisgaier conducted a follow-up study to this lawsuit. She examined Medicaid enrollees’ access to specialist services in order to determine if additional changes in the design or implementation of Medicaid are necessary. Her findings were published as a first-authored paper in the New England Journal of Medicine. Other research she conducted while a PhD student was published in Pediatrics, Sexually Transmitted Diseases, Archives of Pediatric and Adolescent Medicine, Journal of Health Care for the Poor and Underserved, Health & Social Work, and more. Her research won the 2012 Student Research Award for Social Work Research from GADE (PhD program directors from across the country).

Joanna’s work attracted the attention of key policy makers. She and her advisor participated in an Expert Round Table Discussion on access to specialty care for Congress’ Medicaid and CHIP Payment Access Commission. They also hosted a conference at Penn, which explored the potential for system reorganization and improving the efficient use of scarce medical subspecialty resources.

Since graduating in 2011, Joanna has conducted research with the Office of the Inspector General at the U.S. Department of Health & Human Services.