Willingness of eye care practices to evaluate children and accept Medicaid

The willingness of eye care providers to evaluate children or to accept Medicaid may be a barrier to care for those with an abnormal screen.

To determine the proportion of eye care practices that would provide diagnostic evaluation for children and accept Medicaid payment and to evaluate the influence of child age and practice characteristics on provision of care or acceptance of Medicaid.

We conducted a telephone survey of 364 eye care practices in Michigan, which were randomly selected from telephone directories of 26 rural and urban cities as defined by metropolitan statistical areas.

The response rate was 93%. Most eye care practices, but more optometry-listed practices than ophthalmology-listed ones, would evaluate preschool-aged children (88% vs 73%; P <.01) or school-aged children only (11% vs 7%; P <.01). The proportion of practices willing to evaluate preschool-aged children was lower in urban cities compared with rural cities for optometry-listed (83% vs 96%; P <.01) and ophthalmology-listed practices (67% vs 93%; P <.01). Medicaid acceptance among practices that would evaluate children was higher among ophthalmology-listed than optometry-listed practices (74% vs 59%; P =.01) and did not vary by urban or rural status. Practice size was not associated with willingness to provide care for children. However, among practices that would provide care for children, larger practice size was associated with increased odds of Medicaid acceptance in both optometry-listed and ophthalmology-listed practices.

These findings contradict the perception that eye care for children is unavailable. More work is needed to understand the relationship of this availability with the accessibility of eye care.