The Impact of Medicaid Managed Care on Primary Care Physician Participation in Medicaid

Abstract

This study failed to find that increases in Medicaid managed care lead to increased primary care physician participation in Medicaid during the period 1996-2001.

Race, Segregation, and Physicians' Participation in Medicaid

“…We used additional sources of data for several covariates, all of which we describe in more detail. These included the Medicare/Medicaid reimbursement ratio (Menges et al 2001), the percentage of the county's population receiving Medicaid and the county‐level Medicaid managed care penetration rate (Greene, Blustein, and Remler 2005), the ratio of physicians to population (U.S. Department of Health and Human Services 2002), and a measure of Medicaid program hassle (Berman et al 2002).…”

“…Physicians, for example, are generally more likely to accept Medicaid patients when reimbursements are higher (Adams 1995; Mitchell 1983, 1991; Perloff, Kletke, and Neckerman 1986), with some exceptions (Perloff et al 1997). Physicians' participation is lower in wealthier communities (Greene, Blustein, and Remler 2005; Perloff, Kletke, and Neckerman 1986; Perloff et al 1997) and among physicians with stronger credentials (Backus et al 2001; Margolis et al 1992; Sloan, Mitchell, and Cromwell 1978).…”

“…The CTS asked the physicians: “Is the practice accepting all, most, some, or no new patients who are insured through Medicaid, including Medicaid managed care patients?” We then created a dichotomous version of this variable for our analysis, contrasting those physicians accepting any Medicaid patients with those accepting none. This measure was used in a recent study of physicians' participation in Medicaid (Greene, Blustein, and Remler 2005). We repeated our analyses using two alternative measures of physicians' participation.…”

Physician Practice Revenues and Use of Information Technology in Patient Care

“…28 We then examined the interaction of the practice's Medicaid revenue share to test whether Medicaid HMO penetration is related to clinical IT adoption. Information in the CTS does not allow us to directly examine the interaction between revenue source and type.…”

Medicaid Managed Care and the Unmet Need for Mental Health Care among Children with Special Health Care Needs

“…Because carve-outs have been shown to shift mental health services from the inpatient to the outpatient setting, it may also be due to a shortage of outpatient mental health providers (Callahan et al 1995;Chang et al 1998;Hutchinson and Foster 2003;Baker and Afendulis 2005). The greater unmet need for integrated programs and overall Medicaid managed care may be due to insufficient funding, poor capitation systems, inadequate risk adjustment, a reduction in the level of services, or barriers that could lead to low Medicaid participation rates among providers (Greene, Blustein, and Remler 2005).…”