Reimbursement and access to physicians' services under Medicaid

Area of Science:

• Health Services Research
• Medical Economics
• Public Health Policy

Background:

• Physician participation in state Medicaid programs is often linked to reimbursement generosity.
• Previous research suggests reduced state fees may limit Medicaid beneficiaries' access to physician services.

Purpose of the Study:

• To investigate the relationship between physician reimbursement levels and access to ambulatory care for non-elderly Medicaid eligibles.
• To determine if stringent physician reimbursement practices impede access to physician services.

Main Methods:

• Multivariate analyses were employed to examine utilization and site-of-visit patterns.
• The study focused on non-elderly individuals enrolled in state Medicaid programs.

Main Results:

• The study's findings contradict the implication that reduced state fees limit Medicaid eligibles' access to physicians.
• Multivariate analyses indicated that stringent physician reimbursement practices do not impede access to ambulatory care.
• Access was evaluated considering all potential sites where a physician may be seen.

Conclusions:

• Physician reimbursement policies may not directly correlate with reduced access to ambulatory care for Medicaid beneficiaries.
• The study highlights the importance of considering all care sites when assessing access to physician services under Medicaid.