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Qualitative perspectives of primary care providers who treat Medicaid managed care patients
BACKGROUND: 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 experi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150984/ https://www.ncbi.nlm.nih.gov/pubmed/30241523 http://dx.doi.org/10.1186/s12913-018-3516-9 |
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author | Gordon, Sarah H. Gadbois, Emily A. Shield, Renee R. Vivier, Patrick M. Ndumele, Chima D. Trivedi, Amal N. |
author_facet | Gordon, Sarah H. Gadbois, Emily A. Shield, Renee R. Vivier, Patrick M. Ndumele, Chima D. Trivedi, Amal N. |
author_sort | Gordon, Sarah H. |
collection | PubMed |
description | BACKGROUND: 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. METHODS: We 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. RESULTS: Providers 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. CONCLUSIONS: Underinvestment 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. |
format | Online Article Text |
id | pubmed-6150984 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61509842018-09-26 Qualitative perspectives of primary care providers who treat Medicaid managed care patients Gordon, Sarah H. Gadbois, Emily A. Shield, Renee R. Vivier, Patrick M. Ndumele, Chima D. Trivedi, Amal N. BMC Health Serv Res Research Article BACKGROUND: 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. METHODS: We 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. RESULTS: Providers 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. CONCLUSIONS: Underinvestment 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. BioMed Central 2018-09-21 /pmc/articles/PMC6150984/ /pubmed/30241523 http://dx.doi.org/10.1186/s12913-018-3516-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Gordon, Sarah H. Gadbois, Emily A. Shield, Renee R. Vivier, Patrick M. Ndumele, Chima D. Trivedi, Amal N. Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title | Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title_full | Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title_fullStr | Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title_full_unstemmed | Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title_short | Qualitative perspectives of primary care providers who treat Medicaid managed care patients |
title_sort | qualitative perspectives of primary care providers who treat medicaid managed care patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150984/ https://www.ncbi.nlm.nih.gov/pubmed/30241523 http://dx.doi.org/10.1186/s12913-018-3516-9 |
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