Changes in Physicians' Decisions to Treat Medicaid Patients and the Uninsured

HRET, in partnership with the Center for Health Policy Research at the American Medical Association, is analyzing trends in physicians' willingness to treat patients covered by Medicaid and patients with no health insurance. The research project will address the following research questions:

Among the many barriers to health care faced by the growing proportion of poor and uninsured in the United States is their limited access to physician services. A large number of physicians do not accept patients on Medicaid or without health insurance. And the findings of several recent studies suggest that policy levers used to increase access to physician services are no longer as effective as they once were.

Funding: The Robert Wood Johnson Foundation

Partners: American Medical Association
  • Which physicians treat Medicaid and uninsured patients? What factors go into physicians' decisions to treat these patients? Are these decisions affected by the growth of the uninsured population? The growth of managed care?

  • How much discretion do employee physicians and physicians in large group practices have over their Medicaid participation decisions?

  • To what extent are Medicaid patients and uninsured patients concentrated into the practices of a few physicians?

The principal source of data for the project is a series of annual physician surveys conducted between 1983 and 1998. Each survey collected data from a random sample of approximately 4,000 physicians. The study will examine how physicians' decisions to provide services to Medicaid patients and uninsured patients have been affected by recent changes in the health care system - such as the growth of managed care, increased competition among health care providers, the rising proportion of physicians who are employees, and the increasing number of people with no health insurance.

The findings of the analysis will be useful for the development of public policy to increase access to health care among underserved populations.