Quality of Primary Outpatient Care for Medicaid Patients: Does a Practice's Share of Medicaid Patients Matter?

The recently enacted Patient Protection and Affordable Care Act expands eligibility to Medicaid for millions of near­ poor indi­viduals. Given this expansion, policymak­ers need to understand the nature of the disparities that exist in the quality of care Medicaid beneficiaries receive as com­pared to their privately insured counter­parts. Previous research has demonstrated that as the percentage of Medicaid patients in a physician's practice increas­es, health services and the quality of care received by Medicare beneficiaries and the privately insured decrease. Yet, the literature offers very little information about the impact of a practice's proportion of Medicaid patients on the quality of care received by Medicaid patients themselves. The Capstone team analyzed how the proportion of Medicaid revenue received by a physician's practice influences the disparity in quality of care between Medicaid and privately insured patients. The study assessed whether disparities in the quality of care between Medicaid and privately insured patients occur within or between practices, and whether such disparities are themselves associated with the proportion of practice revenue from Medicaid.