Does Primary Care Provider Supply Influence Medicaid Acceptability?

Area of Science:

• Health Services Research
• Health Economics
• Public Health Policy

Background:

• The Affordable Care Act's Medicaid expansion improved healthcare access for low-income individuals.
• Increased Medicaid acceptance by primary care providers in Michigan was a key factor in this improved access.

Purpose of the Study:

• To investigate if the density of healthcare providers influences physician acceptance of new Medicaid patients.
• To understand geographic variations in Medicaid patient acceptance and appointment scheduling.

Main Methods:

• Utilized Michigan simulated patient "secret shopper" data from 2014-2015.
• Employed a difference-in-differences event-study regression analysis.
• Compared Medicaid acceptability and appointment trends in high-density versus low-density provider areas.

Main Results:

• Practices in low-provider-supply areas were not significantly more likely to reject new Medicaid patients one year post-expansion.
• Initial appointment wait times were approximately one day longer in low-supply areas, but this difference diminished over time.
• No significant difference in turning away new Medicaid patients was observed between high- and low-provider-density areas.

Conclusions:

• Newly insured Medicaid patients are successfully accessing care in areas with limited healthcare resources.
• The study indicates that Medicaid expansion effectively improved access to primary care, even in underserved regions.