1. Are Medicaid Patients Seen in Office-Based Practices Getting High-Quality Primary Care?
- Author
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Glied, Sherry A. and Ding, Dong
- Subjects
MEDICAL care surveys ,MEDICAID ,PRIMARY care ,OUTPATIENT medical care ,MEDICAID eligibility ,ELECTRONIC health records ,PATIENT Protection & Affordable Care Act - Abstract
Issue: About three-quarters of nonelderly adult Medicaid patients get their primary care from independent office-based practices, rather than hospital outpatient departments or health centers. But many independent physicians don't accept Medicaid, in part because of its low payment rates. Medicaid-covered care is concentrated in a small share of independent, typically underresourced practices, and this potentially has implications for the quality of care delivered. The Affordable Care Act's Medicaid eligibility expansion and physician fee bump, however, may have changed the distribution or care of patients across independent practices. Goals: Examine the distribution of Medicaid patients across office-based primary care physicians and the impact of a practice's Medicaid patient share on care quality. Methods: Analysis of National Ambulatory Medical Care Survey findings for 2006-2016 and 2018-2019. Key Findings and Conclusions: Medicaid visits have remained concentrated in a minority of practices since Medicaid expansion. From 2014 to 2019, about onethird of sampled office-based primary care physicians accounted for 90 percent of Medicaid office visits. Patients are as likely to receive guideline-recommended care at Medicaid-dominated practices as they are at practices with more non-Medicaid patients, but the former are much less likely than the latter to have adopted electronic health records. This suggests that low payment rates may affect practices' ability to invest in technology that promotes high-quality care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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