Factors identified for Medicaid patients’ use of health centers

Black or Hispanic race or having a significant financial need were factors identified with Medicaid patients seeking primary care at health centers, according to study results published in the Journal of Primary Care & Community Health.

Researchers used 2009 Medicaid fee-for-service claims for 13 states, including Alabama, California, Colorado, Connecticut, Florida, Iowa, Illinois, Mississippi, Montana, North Carolina, Vermont, Texas and West Virginia, to conduct a cross-sectional study comparing patients who used health centers and those who did not use the centers. There were 2,706,763 non-health center users and 357,124 health center users included in the study.

Patient-level predictors of preferential primary care utilization at health centers included Medicaid patients who received Medicare, Temporary Assistance for Needy Families participation, race, ethnicity and chronic disease burden.

Lower odds of health center use were reported for patients with dual-eligibility with Medicare (odds ratio = 0.60; 95% CI, 0.60-0.61) and high chronic disease burden (OR = 0.74; 95% CI, 0.73-0.74). Higher odds were reported for patients participating in Temporary Assistance for Needy Families (OR = 1.22; 95% CI, 1.19-1.24), black patients (OR = 1.35; 95% CI, 1.33-1.36) and Hispanic patients (OR = 1.23; 95% CI, 1.22-1.25). The presence of a health center within the patients’ primary care area strongly predicted health center use (OR = 2.66; 95% CI, 2.63-2.70).

“Given the significant expansion in Medicaid and the large national investment in [health center] capacity that are expected to provide access for the newly insured under Medicaid, it will be critical to understand the extent of variation that exists in [health center] use by Medicaid patients and what factors may be associated with [health center] use,” the researchers wrote.

“Our observation of this pattern among a population restricted to Medicaid fee-for-service patients reinforces the important role that [health centers] play in providing care of minority and vulnerable populations,” the researchers concluded.



Gao YN, et al. J Prim Care Community Health. 2017;doi:10.1177/2150131916687919.


Disclosure: The researchers report no relevant financial disclosures.

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