Full and limited medicaid participation among pediatricians

Abstract

Participation in Medicaid by pediatricians is an important element in the access of low income children to health care. Factors that influence whether participating pediatricians choose to participate fully in the program or to limit their acceptance of Medicaid patients are identified and analyzed. Data were derived from interviews conducted with 814 pediatricians in 13 states. A multivariate analysis examining physician, practice, service area, and Medicaid policy characteristics indicates that policy factors are most influential in the physician's decision whether to participate fully in medicaid programs. Factors found to foster the willingness of pediatricians to participate fully in state Medicaid programs included more competitive levels of reimbursement, minimal delays in reimbursement, and eligibility and benefit policies that minimize interference with the exercise of medical judgment.