In order to measure, understand, and track access to care issues from multiple perspectives, ASPE and CMS approach access using three domains:
■ Consumer Perceptions of Access: What does the person or family enrolled in Medicaid experience? Can they access primary care and specialty care? Do they have a usual source of care? Do they confront barriers in gaining access to care?
■ Provider Reports on Access: What do providers report regarding access to care for Medicaid beneficiaries at their practice?
■ Realized Access: What services are beneficiaries actually using? What are the characteristics of the providers serving Medicaid beneficiaries?
ASPE and CMS consider all three domains important. The objective is to identify data sources and indicators that provide a relatively complete picture of access in each of these three domains at the state-level.