Medicaid & Seniors: Care Delays & Challenges
- Individuals enrolled in both Medicare and Medicaid, known as dual-eligible patients, encounter notable obstacles in accessing timely and effective healthcare.
- The survey of 280 dual-eligible individuals revealed that many face access barriers and delays.
- Negative experiences and a lack of understanding regarding coverage often lead to costly outcomes. Dissatisfaction with care prompted 42% of respondents to visit the emergency room or urgent...
Dual-eligible patients face significant challenges accessing healthcare, including delays for primary care appointments and difficulties navigating the system, impacting their journey. This new report uncovers how combining both Medicare and Medicaid, the primary_keyword, can create hurdles. Survey data reveals that many individuals with secondary_keyword eligibility experience barriers that lead to ER visits and delayed care, further highlighting the need for increased patient support. The study shows that mental health issues and life conditions negatively impact access. News directory 3 is monitoring the story. Understand how negative healthcare experiences are affecting quality of life. Discover what’s next …
Dual-Eligible Patients Face Healthcare Access Challenges
Updated June 27, 2025
Individuals enrolled in both Medicare and Medicaid, known as dual-eligible patients, encounter notable obstacles in accessing timely and effective healthcare. A recent survey conducted by ipsos in partnership with Cityblock Health highlights thes challenges, revealing widespread confusion and delays in care for this growing population. understanding the healthcare experiences of dual-eligible individuals is crucial as their numbers are projected to exceed 15 million by 2028, growing at an annual rate of 6%.
The survey of 280 dual-eligible individuals revealed that many face access barriers and delays. About 24% reported waiting two or more weeks for an appointment with their primary doctor. Furthermore, 38% waited more than 30 minutes for a medical appointment to begin, at least some of the time. 20% found it difficult to access healthcare services.
Negative experiences and a lack of understanding regarding coverage often lead to costly outcomes. Dissatisfaction with care prompted 42% of respondents to visit the emergency room or urgent care at least once in the past year. Another 33% delayed seeking healthcare due to negative experiences with the healthcare system or a doctor, while 25% delayed care as they did not understand their health plan. These findings underscore the need for improved patient education and more coordinated care models.
Mental health struggles and social determinants also play a significant role in access to care. The survey revealed that 54% of respondents experienced sadness at least monthly, 45% reported depression at least monthly, and 42% reported loneliness at least monthly. Additionally, 28% indicated that a lack of reliable transportation impacted their access to care, and a striking 69% reported that money is a day-to-day challenge.
“With nearly two in three dual-eligible patients struggling with their health daily, it’s clear that more needs to be done to provide a trustworthy, effective, and longitudinal care experience for this population and prevent costly consequences like avoidable delays in care and unnecessary ER visits,” said Dr. toyin ajayi, CEO and Co-founder of Cityblock Health.
Ajayi emphasized the importance of outcomes-based care models that proactively support members in navigating their benefits and ensure a more tightly coordinated healthcare experience. Addressing these challenges is essential to improving the health and well-being of dual-eligible individuals and reducing unnecessary healthcare costs.
What’s next
Cityblock Health plans to use these findings to further refine its care model, focusing on proactive support and coordinated care to improve the healthcare experience for dual-eligible individuals.