Primary Care Access to New Patient Appointments for California Medicaid Enrollees: A Simulated Patient Study

• DOI: 10.1370/afm.2502
• Publication Date: 2020-05-12T02:15:22Z
• Authors: Joy Melnikow; Ethan Evans; Guibo Xing; Shauna Durbin; Dominique Ritley; Brock Daniels; Lindsey Woodworth
• Keywords: Reimbursement

<h3>PURPOSE</h3> We undertook a study to evaluate variation in the availability of primary care new patient appointments for Medi-Cal (California Medicaid) enrollees Northern California, and its relationship emergency department (ED) use after Medicaid expansion. <h3>METHODS</h3> placed simulated calls by purported 581 clinicians (PCCs) listed as accepting patients online directories managed plans. Data from California Health Interview Survey, enrollment reports, hospital discharge records were used analyses. developed multilevel, mixed-effect models appointment access. Multiple linear regression was examine between access ED county. <h3>RESULTS</h3> Availability PCC lacking varied significantly across counties multilevel model, ranging 77 (95% CI, 70-81) 472 378-628) per each available appointment. Just 19% PCCs had within state-mandated 10 business days. Clinicians at Federally Qualified Centers higher (rate ratio = 1.56; 95% 1.24-1.97). Counties with poorer enrollees. <h3>CONCLUSIONS</h3> In contrast findings other states, limited counties, despite standard statewide reimbursement rates. more