{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:08:22Z","timestamp":1777615702333,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Our goal was to determine whether state Medicaid expansion and patient insurance statuses affected access to care for ankle sprain patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four pairs of Medicaid expanded (Kentucky, Louisiana, Iowa, and Arizona) and unexpanded (North Carolina, Alabama, Wisconsin, and Texas) states were chosen. Twelve practices from each state (N = 96) were randomly selected from the American Orthopaedic Foot and Ankle Society (AOFAS) directory and called twice to request an appointment for a fictitious 16-year-old with a first-time ankle sprain using either Medicaid insurance or Blue Cross Blue Shield (BCBS) private insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An appointment was obtained at 65.6% clinics when calling with BCBS and at 45.8% with Medicaid (P =.006). There was a significant difference in successful scheduling based on insurance status in Medicaid unexpanded states (P = .007). In all states except Iowa, there were more appointments scheduled using BCBS than with Medicaid. The 3 main reasons for appointment denial were inability to provide an insurance identification number (47.1%), insurance status (23.5%), and whether the patient was referred (17.6%). The waiting period for an appointment did not differ by Medicaid expansion or insurance statuses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients with first-time ankle sprains, access to care is more difficult using Medicaid insurance rather than private insurance, especially in Medicaid unexpanded states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level II prospective cohort study<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400221125375","type":"journal-article","created":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T01:43:56Z","timestamp":1664588636000},"page":"74-79","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Medicaid Patients Face Limited Access to Care for Ankle Sprains in Unexpanded States"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6301-3106","authenticated-orcid":false,"given":"Caroline P.","family":"Hoch","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6996-9472","authenticated-orcid":false,"given":"Daniel J.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher E.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"bibr1-19386400221125375","unstructured":"Centers for Medicare and Medicaid Services. Medicaid. https:\/\/www.medicaid.gov\/medicaid\/index.html. Accessed August 9, 2021."},{"key":"bibr2-19386400221125375","unstructured":"Public Law Patient Protection and Affordable Care Act. https:\/\/www.ihs.gov\/sites\/ihcia\/themes\/responsive2017\/display_objects\/documents\/home\/PL111_148_PPACA.pdf. Accessed April 8, 2021."},{"key":"bibr3-19386400221125375","unstructured":"Kaiser Family Foundation. Status of state action on the Medicaid expansion decision. https:\/\/www.kff.org\/health-reform\/state-indicator\/state-activity-around-expanding-medicaid-under-the-affordable-care-act\/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed April 8, 2021."},{"key":"bibr4-19386400221125375","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200737010-00006"},{"key":"bibr5-19386400221125375","doi-asserted-by":"publisher","DOI":"10.3810\/psm.2001.02.371"},{"key":"bibr6-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200002000-00011"},{"key":"bibr7-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2019.07.008"},{"key":"bibr8-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2013.07.051"},{"key":"bibr9-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31824abf20"},{"key":"bibr10-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117714140"},{"key":"bibr11-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000573"},{"key":"bibr12-19386400221125375","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00303"},{"key":"bibr13-19386400221125375","doi-asserted-by":"publisher","DOI":"10.1177\/1071100721990343"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400221125375","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19386400221125375","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400221125375","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:32:05Z","timestamp":1777411925000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19386400221125375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1177\/19386400221125375"],"URL":"https:\/\/doi.org\/10.1177\/19386400221125375","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]}}}