WASHINGTON (August 2, 2023)--To improve access to high-quality Medicaid services, experts must first locate the gaps in healthcare providers available to patients who rely on this health insurance. Researchers at the George Washington University today launched an interactive online tracking system that identifies states and counties in the United States that suffer from a shortage of primary care providers who see Medicaid patients.
Previous research has demonstrated that only 68% of family physicians accept new Medicaid patients. Other studies have shown gaps in the types of providers who participate in the Medicaid program but the research on where the gaps are is limited.
“We know that many providers do not accept Medicaid because reimbursement is low and the administrative burden is high. But ultimately this is a practice that puts profits ahead of patients,” Patricia (Polly) Pittman, the director of the GW Fitzhugh Mullan Institute for Health Workforce Equity, said. “We have to find a way to entice these providers back to Medicaid.”
Pittman and her colleagues developed the Medicaid Primary Care Workforce Tracker using national data to identify primary care providers with Medicaid claims between 2016 to 2019. The tracker reports the number of Medicaid providers to population ratio and the percentage of all active providers who saw Medicaid patients at state and county levels.
The online tool looks at the contribution of providers offering crucial primary care services. The tracker also puts a spotlight on parts of the state or counties that suffer from a shortage of certain kinds of Medicaid providers–forcing patients to travel long distances to get to a provider. In other cases, the barriers to care can lead to dangerous delays in care, the researchers said.
The Tracker reveals some encouraging, and some alarming, news for Medicaid patients across the nation:
- In 2019, the percent of primary care physicians who provided any appreciable care to Medicaid patients - seeing just 11 or more patients over the year – ranged from 84% in Wisconsin to as low as 61% in New Jersey, suggesting the variability in state Medicaid policy matters in terms of access to care.
- Overall, the number of any type of primary care provider who saw Medicaid patients rose 13% from 2016 to 2019. However, advanced practice nurses and physician assistants made up 95% of the increase.
- The number of Ob-Gyns seeing Medicaid patients actually dropped 2.5% over the 3-year period, with 24 states losing Ob-Gyns who accepted Medicaid over this period. Nearly 44% of U.S. counties had no Medicaid OB/GYNs at all, a worrisome sign given the importance of this kind of primary care for maternal and child health.
- Thirteen states also saw a loss of Medicaid Family Medicine physicians, 21 states saw a loss of Medicaid Internal Medicine Physicians, and 11 states saw a loss of Medicaid Pediatricians.
The tracker will allow state, local and federal policymakers to identify areas with major deficiencies in providers willing to see Medicaid patients. Even more crucially, the tool allows policymakers to make targeted investments to strengthen the Medicaid workforce and improve access for patients.
While the tracker currently examines data from 2016-2019, the team plans to continue to update the tool as more data becomes available.
An analysis using the newly launched Medicaid Primary Care Workforce Tracker was published Aug. 2 in the Forefront section of the journal Health Affairs by Pittman, Candice Chen and other researchers at the GW Fitzhugh Mullan Institute for Health Workforce Equity, which is based at the Milken Institute School of Public Health.
The Medicaid Primary Care Workforce Tracker was supported by the Bureau of Health Workforce (BHW), National Center for Health Workforce Analysis (NCHWA), Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). The contents are those of the authors and do not necessarily represent the views of, nor endorsement by HRSA, HHS, or the U.S. Government.