Abstract
More individuals have health care coverage after the passage of the monumental federal health care reform law, the Patient Protection and Affordable Care Act (ACA). However, the promise of the ACA cannot be fulfilled if there are not enough physicians participating in Medicaid to sustain the huge beneficiary population. With a low provider to beneficiary ratio in Medicaid, individuals are forced to go without needed care or wait weeks, if not months, to be seen by a medical provider. Long waits to see a health care provider can have life or death implications, raising the urgency of this policy problem. This study analyzed the relationship between physician participation in Medicaid and a variety of environmental factors, such as reimbursement rates, practice characteristics and personal traits. My research sought to identify which factors are the most influential in a physician’s decision to participate in the governmental health care program. I employed a series of ordered logistic regression and logistic regression models in my quantitative analysis. Data from the 2012 and 2013 National Ambulatory Medical Care Survey were used to evaluate the relationship between influencing factors and participation, as physicians prepared for the sharp increase in the Medicaid population due to the 2014 ACA implementation. The quantitative analysis demonstrated that reimbursement rates may not actually be the golden ticket to improving physician participation, while the ethnicity of a physician and region of practice are far more influential in a physician’s decision to participate in Medicaid. A central finding from my study indicated the ethnicity of a physician is a critical factor impacting Medicaid participation; minority physicians are more likely to participate in Medicaid than non-minority physicians. Another important finding showed physicians who practice in rural locations are more likely to participate in Medicaid than those who practice in urban areas. My study has policy implications for lawmakers and Medicaid officials. It is vital that the federal and state governments increase physician participation to deliver on the promise of the ACA and subsequently improve the health and well-being of millions of Medicaid beneficiaries nationwide.