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Member Research & Reports

Member Research & Reports

Kentucky: Are New Medicaid Patients Able to Access Care in Areas with Limited Providers?

A new publication from the University of Kentucky College of Public Health examines whether primary care whether a given physician’s willingness to accept new Medicaid patients is moderated by the availability of other providers in close proximity. Dr. Joseph A. Benitez of the University of Kentucky College of Public Health Department of Health Management and Policy is the first author, alongside collaborators Dr. Renuka Tipirneni of the University of Michigan Ann Arbor, Dr. Victoria A. Perez of the Indiana University School of Public and Environmental Affairs, and Dr. Matthew M. Davis of Northwestern University.

Following the Affordable Care Act’s Medicaid expansions, access to care improved through elevated coverage rates among the low-income population. In Michigan, a major factor contributing to improved access among low-income patients was increased Medicaid acceptance in primary care settings. Prior evidence shows substantial geographic variation pre-acceptance and post-acceptance of Medicaid.

The study uses Michigan simulated patient (i.e., “secret shopper”) data collected during 2014 and 2014. Through one year after Michigan’s Medicaid expansion, practices in low-supply areas appeared no more likely to turn away a newly insured Medicaid patient than a practice in a supply-rich area. The wait times for patients in a low-supply area were about a day longer than for patients in supply-rich areas through four months after the expansion, though this difference dissipated through eight  and 12 months after the expansion.

“These findings indicate that newly insured Medicaid patients are gaining access to care in settings with limited health care supply,” the authors conclude.