Table 3.
Multivariable Analysis of Association of PCP and Practice Characteristics with Medicaid Acceptancea
| Unadjusted Odds Ratio of Medicaid Acceptance (OR, 95% CI) | Adjustedb Odds Ratio of Medicaid Acceptance (aOR, 95% CI) | |
|---|---|---|
|
Personal and
Professional characteristics | ||
| Female Gender | 1.59 (1.28-1.98)d | 1.32 (1.01-1.72)c |
| Race | ||
| White | [ref] | [ref] |
| Black/African American | 3.93 (1.80-8.57)c | 3.46 (1.45-8.25)c |
| Asian/Pacific Islander | 1.76 (1.20-2.58)c | 1.84 (1.21-2.80)c |
| Other | 1.94 (1.04-3.62)c | 1.79 (0.84-3.80) |
| Ethnicity, Hispanic | 1.88 (0.79-4.48) | 1.54 (0.56-4.22) |
| Years in Practice | ||
| <10 years | [ref] | [ref] |
| 10-20 years | 0.69 (0.51-0.93)c | 0.87 (0.62-1.22) |
| >20 years | 0.51 (0.38-0.68)d | 0.82 (0.58-1.15) |
| Non-physician provider (vs. physician provider) | 4.78 (3.09-7.40)d | 2.21 (1.32-3.71)c |
| Specialty | ||
| Family medicine | [ref] | [ref] |
| Internal medicine | 1.43 (1.12-1.83)c | 1.47 (1.09-1.97)c |
| Nurse practitioner | 7.81 (3.95-15.45)d | 3.53 (1.64-7.61)c |
| Physician Assistant | 4.07 (2.32-7.16)d | 1.83 (0.94-3.56) |
| Other | 2.86 (1.21-6.79)c | 2.02 (0.75-5.45) |
| Board Certified | 0.57 (0.42-0.77)d | 0.92 (0.64-1.32) |
| Payment arrangement | ||
| Fee-for-service | [ref] | [ref] |
| Salary predominant | 3.02 (2.36-3.85)d | 2.09 (1.58-2.77)d |
| Mixed payment | 1.34 (0.98-1.84) | 1.43 (0.99-2.07) |
| Other payment arrangements | 2.44 (1.01-5.93)c | 1.33 (0.51-3.49) |
|
PCP
attitudes | ||
| Capacity very/moderately important | 0.53 (0.41-0.68)d | 0.59 (0.44-0.79)d |
| Reimbursement very/moderately important | 0.64 (0.51-0.79)d | 0.86 (0.67-1.10) |
| Specialist availability very/moderately important | 0.95 (0.76-1.17) | 1.11 (0.86-1.42) |
| Illness burden of patients very/moderately important | 1.02 (0.83-1.27) | 1.03 (0.81-1.32) |
| Psychosocial needs of patients very/moderately important | 1.10 (0.89-1.37) | 1.14 (0.89-1.45) |
| Provided care to the underserved in past 3 years | 1.64 (1.33-2.03)d | 1.35 (1.05-1.73)c |
| Expressed commitment to caring for underserved | 1.16 (1.13-1.19)d | 1.14 (1.11-1.18)d |
|
Practice
characteristics | ||
| Small practice with ≤5 providers (vs. large practice) | 1.18 (0.95-1.47) | 1.27 (0.99-1.63) |
| Urban (vs. rural/suburban) | 0.69 (0.53-0.89)c | 0.97 (0.72-1.31) |
| Federally qualified health center | 2.40 (1.66-3.47)d | 1.08 (0.70-1.65) |
| Mental health co-location | 1.99 (1.42-2.79)d | 1.16 (0.79-1.71) |
| Predominant payer mix | ||
| Private insurance | [ref] | [ref] |
| Medicaid/Healthy Michigan Plan | 8.64 (6.14-12.15)d | 7.31 (5.05-10.57)d |
| Medicare | 1.94 (1.47-2.55)d | 2.04 (1.52-2.73)d |
| Mixed | 3.32 (2.05-5.37)d | 3.76 (2.24-6.30)d |
a
Each cell represents a separate bivariate or multivariable logistic regression model.
b
Adjusted for covariates of gender, years in training, physician vs. non-physician provider, board certification, urbanicity, federally qualified health center status, predominant payer mix, except for when independent variable included in list.
c
p < 0.05
d
p < 0.001