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Geographic expansion of Medicaid managed care organizations: assessing access to primary care in nonmetropolitan counties
Geographic expansion of Medicaid managed care organizations: assessing access to primary care in nonmetropolitan counties
RUPRI Center for Rural Health Policy Analysis, issuing body. Rural Health Research & Policy Centers, issuing body. Rural Policy Research Institute (U.S.), issuing body.
Publication:
Iowa City, IA : Rural Policy Research Institute, March 2021
From 2012 to 2018, many states' Medicaid programs increased the share of beneficiaries enrolled in comprehensive risk-based managed care organizations (MCOs), but little research has focused on the impact of this decision on nonmetropolitan areas. This brief assesses access to primary care in nonmetropolitan counties for Medicaid recipients who are newly covered through Medicaid MCOs. We calculated and analyzed a "PCP (primary care provider) access score" (summarizing actual travel distances to primary care) using geospatial methods and assessed the relationship between stronger state policies on network adequacy to observed PCP access scores in nonmetropolitan settings. Key Findings. (1) Nonmetropolitan counties that had Medicaid MCOs prior to 2012 experienced better access to primary care--as measured by our PCP access score--than nonmetropolitan counties that expanded to Medicaid MCO coverage after 2012. (2) Nonmetropolitan counties in states that specify stronger network adequacy travel time requirements for primary care providers (PCPs) had better PCP access scores on average than those in states that allow longer travel times. (3) Among nonmetropolitan counties that were newly served by Medicaid MCOs in 2012-2018, a segment of roughly 45,000 Medicaid recipients experienced relatively low PCP access scores and thus less access to primary care.
Copyright:
The National Library of Medicine believes this item to be in the public domain. (More information)