Using data from four states, Avital B. Ludomirsky and coauthors found that, of those that contracted with Medicaid, on average just 25 percent of primary care physicians provided 86 percent
of care and 25 percent of specialists provided 75 percent of care.
On top of that, the study confirmed that inadequate or outdated provider directories vastly misrepresent the availability of care.
The result, the authors argue, is that current network adequacy standards may not reflect actual access to the Medicaid program; and that new methods that account for beneficiary preferences and physician willingness to serve Medicaid patients are needed to enforce these standards.
Please join Dr. Ludomirsky, a pediatrician and postdoctoral fellow at the Yale School of Medicine, on May 17th for a detailed discussion of the paper’s data, methods, and conclusions. Health Affairs Senior Editor Leslie Erdelack will host.
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