Recent Trends in Pediatrician Participation in Medicaid

Perloff, Janet D.; Kletke, Phillip R.; Neckerman, Kathryn M.

doi:10.1097/00005650-198608000-00010

Cited by 38 publications

(27 citation statements)

References 9 publications

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“…However, other studies have shown that much of the increase simply reflects a shift of patients from public sites (e.g., public health departments and community health clinics) to private physicians' offices (Long, Settle, and Stuart 1986;Wade 1992;Cohen and Cunningham 1993;Baker and Royalty 1997;Gruber, Adams, and Newhouse 1997). Studies also have found that higher Medicaid enrollment levels independently increase the extent of physicians' participation in Medicaid (Held and Holahan 1985;Mitchell 1991;Adams 1994;Perloff, Kletke, and Neckerman 1986). Furthermore, at least one study found a significant negative effect of administrative inefficiency on physician participation; Perloff, Kletke, and Neckerman (1986) found that physicians who experienced delays in payment were more likely to limit the extent of their participation.…”

Section: Previous Researchmentioning

confidence: 99%

“…Several studies have found significant positive correlations between relative Medicaid fees and both Medicaid participation and caseloads among office-based physicians in general (Sloan, Mitchell, and Cromwell 1978;Hadley 1979;Held and Holahan 1985;Mitchell 1991;Adams 1994) and pediatricians in particular (Perloff, Kletke, and Neckerman 1986;Margolis et al 1992). However, other studies have shown that much of the increase simply reflects a shift of patients from public sites (e.g., public health departments and community health clinics) to private physicians' offices (Long, Settle, and Stuart 1986;Wade 1992;Cohen and Cunningham 1993;Baker and Royalty 1997;Gruber, Adams, and Newhouse 1997).…”

Section: Previous Researchmentioning

confidence: 99%

“…Studies also have found that higher Medicaid enrollment levels independently increase the extent of physicians' participation in Medicaid (Held and Holahan 1985;Mitchell 1991;Adams 1994;Perloff, Kletke, and Neckerman 1986). Furthermore, at least one study found a significant negative effect of administrative inefficiency on physician participation; Perloff, Kletke, and Neckerman (1986) found that physicians who experienced delays in payment were more likely to limit the extent of their participation.…”

Section: Previous Researchmentioning

confidence: 99%

See 2 more Smart Citations

The Use of EPSDT and Other Health Care Services by Children Enrolled in Medicaid: The Impact of OBRA'89

Gavin

Adams

Herz³

et al. 1998

Milbank Quarterly

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To increase the participation of Medicaid children in the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program and to improve their health, Congress included several provisions in the Omnibus Budget Reconciliation Act of 1989 (OBRA’89) that addressed problematic program features. The impact of these provisions on children's health service use was investigated in a study funded by the Health Care Financing Administration. After conducting site visits to four states, the authors analyzed claims data for the children residing there and found evidence that, in 1992, these states placed a higher priority on improving the effectiveness of EPSDT than they did before 1989. The states’ efforts to expand the EPSDT provider base and to enhance outreach and service provision were either directly or indirectly inspired by OBRA’89. The authors also found evidence of a significant impact on provider participation and caseloads and on children’s use of both preventive care and diagnostic and treatment services. However, the effects were modest in comparison to the size of the progress that is required.

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Section: Previous Researchmentioning

confidence: 99%

Section: Previous Researchmentioning

confidence: 99%

Section: Previous Researchmentioning

confidence: 99%

See 1 more Smart Citation

The Use of EPSDT and Other Health Care Services by Children Enrolled in Medicaid: The Impact of OBRA'89

Gavin

Adams

Herz³

et al. 1998

Milbank Quarterly

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show abstract

“…656,657,658,659 Studies that have used longitudinal changes in Medicaid reimbursement policies within states to address this question, however, have found mixed results . Coburn, Long, and Marquis 660 used changes in Medicaid reimbursement policies in Maine and Massachusetts to assess physician participation in Medicaid and service utilization, and found that fluctuations in reimbursement rates had no effect on either outcome .…”

Section: The Evidencementioning

confidence: 99%

Controlling Health Care Spending in Massachusetts: An Analysis of Options

Eibner¹,

Hussey²,

Ridgely³

et al. 2009

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“…4 Since that time, numerous national and state-level studies have documented physician nonparticipation in Medicaid, as well as limited participation by many of those accepting Medicaid patients. [5][6][7][8] During the 1990s, when states dramatically increased Medicaid managed care enrollment from less than 10% to 56% of all Medicaid recipients, 9 the expectation was that managed care would catalyze physicians to participate in Medicaid. In fact, after curtailing program costs, the principal reason cited by policy-makers for embracing Medicaid managed care was to increase mainstream provider participation in Medicaid.…”

mentioning

confidence: 99%