Related Experiment Video
Updated: Mar 27, 2026
Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Access is Not Enough: Characteristics of Physicians Who Treat Medicaid Patients
Kimberley H Geissler1, Benjamin Lubin, Keith M Marzilli Ericson
1*University of Massachusetts-Amherst School of Public Health and Health Sciences, Amherst †Questrom School of Business, Boston University, Boston ‡National Bureau of Economic Research, Cambridge, MA.
Background:
Access to physicians is a major concern for Medicaid programs. However, little is known about relationships between physician participation in Medicaid and the individual-level and practice-level characteristics of physicians.
Methods:
We used the 2011 Massachusetts All Payer Claims Database, containing all commercial and Medicaid claims; we linked with data on physician characteristics. We measured Medicaid participation intensity (fraction of the physician's patient panel with Medicaid) for primary care physicians (PCPs) and medical specialists. We measured influence of physicians within a patient referral network using eigenvector centrality. We used regression models to associate Medicaid intensity with physician individual-level and practice-level characteristics.
Findings:
About 92.6% of physicians treated at least 1 Medicaid patient, but the median physician's panel contained only 5.7% Medicaid patients. Medicaid intensity was associated with physician training and influence for PCPs and specialists. For medical specialists, a 1 percentage point increase in Medicaid intensity was associated with a lower probability of being board certified (-0.22 percentage points; 95% CI, -0.30, -0.14), lower probability of attending a domestic medical school (-0.14 percentage points; 95% CI, -0.22, -0.05), having attended a less well-ranked domestic medical school (0.23 ranks; 95% CI, 0.15, 0.30), and having slightly less influence in the referral network. PCPs displayed similar results but high Medicaid intensity physicians had substantially less influence in the referral network.
Conclusions:
Medicaid participation intensity shows substantial variation across physicians, indicating limits of binary participation measures. Physicians with more Medicaid patients had characteristics often perceived by patients to be of lower quality.
Insights
Physicians with more Medicaid patients often have characteristics perceived as lower quality, impacting access to care. This study highlights variation in physician Medicaid participation intensity.
Area of Science:
- Health Services Research
- Physician Economics
- Healthcare Policy
Background:
- Physician participation in Medicaid is crucial for program access.
- Limited understanding exists regarding factors influencing physician Medicaid involvement.
Purpose of the Study:
- To investigate the relationship between physician characteristics and Medicaid participation intensity.
- To analyze how individual and practice-level factors correlate with the proportion of Medicaid patients a physician serves.
Main Methods:
- Utilized the 2011 Massachusetts All Payer Claims Database, linking claims data with physician characteristics.
- Measured Medicaid participation intensity as the fraction of a physician's patient panel with Medicaid.
- Employed regression models to associate Medicaid intensity with physician attributes and referral network influence (eigenvector centrality).
Main Results:
- While 92.6% of physicians treated Medicaid patients, the median panel comprised only 5.7% Medicaid patients.
- Higher Medicaid intensity in specialists correlated with lower board certification probability, domestic medical school attendance, and lower-ranked medical schools.
- Physicians with higher Medicaid intensity, particularly PCPs, exhibited less influence within referral networks.
Conclusions:
- Medicaid participation intensity varies significantly among physicians, exceeding simple binary measures.
- Physicians serving a higher proportion of Medicaid patients often possess characteristics perceived by patients as indicative of lower quality care.
Related Concept Videos
01:22Standards of Care I
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:17Healthcare Agencies II
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...