Design: A survey of physician participation in public and private health insurance programs was mailed to state-stratified random samples of pediatrician fellows of the American Academy of Pediatrics in 1993 and in 2000. Findings: An analysis of the survey data shows that overall, significantly more pediatricians reported that they accepted all Medicaid patients in 2000 than in 1993. However, respondents in private office-based settings were significantly less likely than those practicing in safety net settings to accept all Medicaid patients. Moreover, this difference increased over time. Self-employed pediatricians were also less likely to accept all Medicaid patients than employee pediatricians, although this difference narrowed over time. Although the main effects of practice capacity and medical school (US/Canadian medical school graduates vs other international graduates/IMGs) were not significant, trend interaction effects were. Respondents practicing at over-capacity were significantly more likely to accept all Medicaid patients than those at or below capacity in 2000, as were IMGs. Conclusion: With significantly higher participation in Medicaid, (1) there is less room to further increase provider participation among safety net providers than among private office-based pediatricians, and (2) pediatricians accepting all Medicaid patients are more likely to be operating above capacity. Implications: To promote equal access to health care by Medicaid patients as by private patients, and to curtail the concentration of Medicaid patients in overloaded practices, states should review Medicaid policies to ensure that there are sufficient incentives for child health providers to extend practice resources to serve new Medicaid enrollees.
Learning Objectives: To examine changes in pediatrician participation in the Medicaid program in 1993 and 2000
Keywords: Pediatrics, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.