Tracking Changes in Primary Care Clinicians' Medicaid Participation Using Novel Methods.

Area of Science:

• Health Services Research
• Public Health Policy
• Healthcare Economics

Background:

• Medicaid beneficiaries face healthcare access challenges due to fluctuating clinician participation.
• Understanding trends in primary care clinician engagement with Medicaid is vital for healthcare policy.

Purpose of the Study:

• To analyze the evolution of primary care clinicians' engagement with Medicaid from 2016 to 2019.
• To identify factors associated with changes in the number of Medicaid enrollees served by clinicians.

Main Methods:

• Longitudinal analysis of Transformed Medicaid Statistical Information System Analytic Files (TAFs) data.
• Examined annual changes in unique Medicaid enrollees served by 220,665 clinicians across 40 states.
• Defined major changes as exceeding 90% of baseline enrollee volume and assessed associations with clinician, practice, and state characteristics.

Main Results:

• Approximately 60% of clinicians maintained stable Medicaid enrollee volumes.
• Nearly 20% of clinicians experienced substantial increases or decreases in patient volume.
• Higher baseline volume and community health center affiliation correlated with stability; rural settings were linked to higher odds of major decreases.

Conclusions:

• Medicaid clinician participation is dynamic, with a notable proportion experiencing significant shifts.
• Policies supporting consistent clinician engagement and stable provider networks are essential for safeguarding access to care.
• Monitoring participation trends is critical amidst potential Medicaid funding and eligibility changes.