Medicaid patients' access to office-based obstetricians.
Recent expansion of the eligibility of low-income pregnant women for Medicaid-funded prenatal care may be jeopardized by undersupplies of obstetricians and gynecologists (OB/GYNs) in rural and urban low-income areas and by widely reported declines in the number of OB/GYNs willing to accept Medicaid patients. This paper examines the availability of office-based obstetric care to Medicaid patients in Illinois. We present and test a model of the determinants of Medicaid participation by private, office-based OB/GYNs that highlights the role of residential segregation and practice economics. We find that a large growth in demand for obstetrical care or the enhancement of Medicaid fees is unlikely to have a major effect on OB/GYN participation in Medicaid. We conclude that improving access will require expanding the supply of providers in underserved areas.
Fossett
J W
JW
Department of Public Administration and Policy, State University of New York, Albany 12222.
Perloff
J D
JD
Kletke
P R
PR
Peterson
J A
JA
D004608:Eligibility Determination; D005251:Fees, Medical; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois; D008484:Medicaid / Q000458:organization & administration*; D015233:Models, Statistical; D009774:Obstetrics / Q000191:economics*; D009819:Office Visits / Q000191:economics; D011203:Poverty; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*; D013221:State Health Plans; D014481:United States