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.
Department of Public Administration and Policy, State University of New York, Albany 12222.
J W
JW
Fossett
J D
JD
Perloff
P R
PR
Kletke
J A
JA
Peterson
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