Abstract
BackgroundDeclining job satisfaction and concurrent reductions in Medicaid participation among primary care providers have been documented, but there is limited qualitative work detailing their first-hand experiences treating Medicaid patients. The objective of this study is to describe the experiences of some primary care providers who treat Medicaid patients using in-depth qualitative analysis.MethodsWe conducted qualitative interviews with 15 primary care providers treating Medicaid patients in a Northeastern state. Participant recruitment efforts focused on including different types of primary care providers practicing in diverse settings. Qualitative interviews were conducted using a semi-structured interview protocol. We developed a coding scheme to analyze interview transcripts and identify themes.ResultsProviders expressed challenges effectively meeting their patients’ needs under current policy. They described low Medicaid reimbursement and underinvestment in care coordination programs to adequately address the social determinants of health. Providers shared other concerns including poor access to behavioral health services, discontinuous Medicaid coverage due to enrollment and renewal policies, and limited reimbursement for alternative pain treatment. Providers offered their own suggestions for the allocation of financial investments, Medicaid policy, and primary care practice.ConclusionsUnderinvestment in primary care in Medicaid may detract from providers’ professional satisfaction and hinder care coordination for Medicaid patients with complex healthcare needs. Policy solutions that improve the experience of primary care providers serving Medicaid patients are urgently needed to ensure sustainability of the workforce and improve care delivery.
Highlights
Declining job satisfaction and concurrent reductions in Medicaid participation among primary care providers have been documented, but there is limited qualitative work detailing their first-hand experiences treating Medicaid patients
During analysis of the physician interviews, distinct themes arose that were independent from the original goal of the interviews and were shared across participants
Providers described challenging experiences meeting the needs of their Medicaid patients and described a strained relationship with Medicaid managed care
Summary
Declining job satisfaction and concurrent reductions in Medicaid participation among primary care providers have been documented, but there is limited qualitative work detailing their first-hand experiences treating Medicaid patients. The objective of this study is to describe the experiences of some primary care providers who treat Medicaid patients using in-depth qualitative analysis. There is limited qualitative work focusing on the first-hand experiences of physicians who deliver care to the Medicaid managed care population [15,16,17]. Gordon et al BMC Health Services Research (2018) 18:728 perspectives are rarely considered in administrative strategies, despite the reliance on primary care in many cost-containment and quality improvement programs at the state and federal levels. Previous qualitative studies of physicians’ experiences treating Medicaid managed care patients were published over 15 years ago after the initial growth of managed care [18]. Over the past several decades, Medicaid managed care has grown rapidly, and on average, 77% of current state Medicaid beneficiaries are enrolled in managed care [19, 20]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
