Abstract
Recent expansion of Medicaid eligibility for pregnant women and increased reimbursement to physicians who provide perinatal services were designed to improve access to care. Family physicians provide a relatively high proportion of care to pregnant women on Medicaid, especially in rural areas. We surveyed all family physicians who provide obstetric services in 26 northern California counties regarding these changes and perceived barriers to providing obstetric care to women on Medicaid. Of surveyed physicians who limited the number of their Medicaid obstetric patients, 58% stated that recent Medicaid policy changes had increased their willingness to accept new Medicaid obstetric patients. Despite these policy changes, administrative issues and poor reimbursement were cited as the two most notable barriers to providing obstetric care to women on Medicaid. Fear of being sued by Medicaid patients is still seen as a barrier by physicians who have recently discontinued practicing obstetrics and by those who continue to care for a large number of Medicaid obstetric patients.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Nesbitt T. S., Connell F. A., Hart L. G., Rosenblatt R. A. Access to obstetric care in rural areas: effect on birth outcomes. Am J Public Health. 1990 Jul;80(7):814–818. doi: 10.2105/ajph.80.7.814. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nesbitt T. S., Scherger J. E., Tanji J. L. The impact of obstetrical liability on access to perinatal care in the rural United States. J Rural Health. 1989 Oct;5(4):321–335. doi: 10.1111/j.1748-0361.1989.tb00993.x. [DOI] [PubMed] [Google Scholar]
- Onion D. K., Mockapetris A. M. Specialty bias in obstetric care for high-risk socioeconomic groups in Maine. J Fam Pract. 1988 Oct;27(4):423–427. [PubMed] [Google Scholar]
- Piper J. M., Ray W. A., Griffin M. R. Effects of Medicaid eligibility expansion on prenatal care and pregnancy outcome in Tennessee. JAMA. 1990 Nov 7;264(17):2219–2223. [PubMed] [Google Scholar]
- Rosenblatt R. A., Whelan A., Hart L. G. Obstetric practice patterns in Washington state after tort reform: has the access problem been solved? Obstet Gynecol. 1990 Dec;76(6):1105–1110. [PubMed] [Google Scholar]
- Schwarz R. H. Infant mortality and access to care. Obstet Gynecol. 1989 Jan;73(1):123–124. [PubMed] [Google Scholar]