Factors That Influence the Willingness of Private Primary Care Pediatricians to Accept More Medicaid Patients

Berman, Steve; Dolins, Judith Cohen; Tang, Suk-fong S.; Yudkowsky, Beth K.

doi:10.1542/peds.110.2.239

Cited by 134 publications

(97 citation statements)

References 4 publications

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“…Many physicians are unwilling to accept Medicaid patients because of low payment rates and administrative hassles and are even less willing to provide charity care. [2][3][4] In addition, immigrants with limited English-speaking proficiency often have communication problems with providers, thus contributing to lower utilization of services, lower rating of care, and less satisfaction with care. [5][6][7][8][9] To reduce barriers to care for people with limited English proficiency, recent federal and state policies have directed providers to provide linguistic services for these patients.…”

mentioning

confidence: 99%

Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

Yoon¹,

Grumbach²,

Bindman³

2004

The Journal of the American Board of Family Medicine

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Background: National studies report patients with limited English proficiency (LEP) have difficulty finding bilingual physicians; however, it is unclear whether this situation is primarily a result of an inadequate supply of bilingual physicians or a lack of the insurance coverage necessary to gain access to bilingual physicians. In California, 12% of urban residents are Spanish-speaking with some limited proficiency in English. The majority of these residents (67%) are uninsured or on Medicaid.Methods: In 2001, we performed a mailed survey of a probability sample of primary care and specialist physicians practicing in California. We received 1364 completed questionnaires from 2240 eligible physicians (61%). Physicians were asked about their demographics, practice characteristics, whether they were fluent in Spanish, and whether they had Medicaid or uninsured patients in their practice.Results: Twenty-six percent of primary care and 22% of specialist physicians in the 13 urban study counties reported that they were fluent in Spanish. This represented 146 primary care and 66 specialist physicians who spoke Spanish for every 100,000 Spanish-speaking LEP residents. In contrast to the general population, there were only 48 Spanish-speaking primary care and 29 specialist physician equivalents available for every 100,000 Spanish-speaking LEP patients on Medicaid and even fewer (34 primary care and 4 specialist) Spanish-speaking physician equivalents for every 100,000 Spanishspeaking physician equivalents for uninsured Spanish-speaking LEP patients.

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mentioning

confidence: 99%

Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

Yoon¹,

Grumbach²,

Bindman³

2004

The Journal of the American Board of Family Medicine

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“…26 The clinical availability of pediatric physicians has also been adversely affected by the increased amount of time they must spend on practice management because of the everincreasing amount of paperwork required to obtain payment. 27 Thus, strategies that decrease time spent on these nonclinical responsibilities can effectively increase the clinical availability and effectiveness of all pediatric physicians. Providing medical home-based, comprehensive care also would improve clinical effectiveness by increasing the pediatrician' s ability to provide the full range of services needed for optimal child health.…”

Section: Changes In the Nature Of Pediatric Practicementioning

confidence: 99%

Pediatrician Workforce Policy Statement

Basco¹,

Rimsza²

2013

Pediatrics

115

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This policy statement reviews important trends and other factors that affect the pediatrician workforce and the provision of pediatric health care, including changes in the pediatric patient population, pediatrician workforce, and nature of pediatric practice. The effect of these changes on pediatricians and the demand for pediatric care are discussed. The American Academy of Pediatrics (AAP) concludes that there is currently a shortage of pediatric medical subspecialists in many fields, as well as a shortage of pediatric surgical specialists.

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“…Low Medicaid payment is the primary reason that physicians limit participation in the program with resulting barriers to patient access for primary care and subspecialty health care services. [16][17][18][19][20][21][22] Even at academic medical centers that serve as "safety nets" for uninsured or underinsured patients, reduced access may be reflected by significantly longer wait times for subspecialty care. 23 Hence, the initial intent of Title XIX to provide truly equal access to quality primary and subspecialty care has not been fulfilled.…”

Section: Financing and Paymentmentioning

confidence: 99%

“…Other documented reasons why providers decline or limit participation in Medicaid include delayed or unpredictable payments, confusing or burdensome payment policies and paperwork, and nonadherence to scheduled visits. 17,18,22 Although The AAP proposes the following recommendations for federal and/or state action:…”

Section: Financing and Paymentmentioning

confidence: 99%

Medicaid Policy Statement

Chiu,

Hudak,

Snider

et al. 2013

Pediatrics

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Medicaid insures 39% of the children in the United States. This revision of the 2005 Medicaid Policy Statement of the American Academy of Pediatrics reflects opportunities for changes in state Medicaid programs resulting from the 2010 Patient Protection and Affordable Care Act as upheld in 2012 by the Supreme Court. Policy recommendations focus on the areas of benefit coverage, financing and payment, eligibility, outreach and enrollment, managed care, and quality improvement.

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Factors That Influence the Willingness of Private Primary Care Pediatricians to Accept More Medicaid Patients

Cited by 134 publications

References 4 publications

Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

Pediatrician Workforce Policy Statement

Medicaid Policy Statement

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