Analysis of Medicaid Provider Supply: Overall, Preventive Care, and DentalServices. Year Two Report

摘要

EPSDT was added to the Medicaid program in 1967 by P.L. 90-248 to providescreening and preventive care, as well as referral for services necessary to correct health problems identified through screening. Because of concerns over low EPSDT participation rates among both beneficiaries and providers. Congress passed sections of OBRA-89 that set standards for performance at the State level, created incentives for greater provider participation and broadened the scope of services covered. This report presents the analysis of changes in physician and dental provider supply as a result of the OBRA89 provisions specifically related to providers: that States allow participation by providers who wish to furnish one or more, but not all diagnostic and treatment services; and that States set payment rates to ensure that the availability of obstetrical and pediatric services for Medicaid recipients are comparable to that of the general population within the same geographic area. The report has seven major sections: (1) an overview of the State-specific policy changes believed to affect provider participation and supply of preventive or EPSDT services from 1989 to 1992; (2) data; (3) methods; (4) results on changes in the counts of dental and non-dental providers, by type; practice size; and place of service; (5) changes in provider participation rates in the study States; (6) descriptive analysis of access measures and service concentration in 1989 and 1992, focusing on changes in enrollee/provider ratios, 'shortage' counties and concentration of service provision; and (7) summary of the findings for 1989.