Nearly one-third of physicians enrolled in Medicaid don’t treat patients covered by the program, according to a study published Feb. 2 in Health Affairs.
A team led by researchers at Portland-based Oregon Health & Science University analyzed physician enrollment files and Medicaid claims data between 2019 and 2021 for five physician specialties: cardiology, dermatology, ophthalmology, primary care and psychiatry.
Researchers found nearly 28% of enrolled physicians did not provide care to any Medicaid beneficiaries in 2021. This disparity was particularly pronounced in psychiatry, with more than 40% of enrolled psychiatrists not treating Medicaid patients.
The study authors referred to these clinicians as “ghost physicians,” noting some may be listed as Medicaid participants due to health system contracting or employment obligations, while others enroll even though their schedules are already full with commercially insured patients, according to a Feb. 2 news release.
At the same time, one-third of enrolled physicians cared for high annual volumes of Medicaid patients, suggesting that access to care is shouldered by a smaller segment of the workforce.
The access gaps identified in the study carry broader implications for patient outcomes and healthcare spending, the authors said.
“Low physician participation in Medicaid is a commonly cited reason for access gaps and unmet need in Medicaid,” lead author Jane Zhu, MD, associate professor of medicine in the OHSU School of Medicine, said in the release. “If patients aren’t able to access the care they need, they may delay or forego care altogether, which is not only bad for patient outcomes, but also bad for the health system overall.”
