Determinants of Physicians’ Acceptance of New Medicaid Patients

Medicaid plays a significant role in the healthcare of millions of U.S. families and individuals, and office-based physician practices are an important part of the national health care delivery system. Yet access to these providers has been and continues to be a challenge for Medicaid beneficiaries. Exacerbating the issue is the recent expansion of insurance coverage under the Affordable Care Act. This study explores this national conundrum from the physicians’ perspective. The impact of practice characteristics, compensation and performance measures are examined on physicians’ propensity to accept new Medicaid patients. This study draws upon data from the 2008 Health Tracking Physician Survey restricted-use file and is the first to provide for a comprehensive look at the determinants of physician acceptance. The approach is rooted in the economic theory of control, agency theory. The most significant factors found to be associated with diminished physician propensity for Medicaid access include: no present participation, having an ownership interest in the practice, operating as a one- or two-physician sized practice, operating as a primary care physician, low relative geographic physician reimbursement, lacking supportive clinical information technology and gender. Knowing what determinants are associated with physicians’ decision may provide opportunities for public policy solutions. Copyright International Atlantic Economic Society 2015