A Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries

• Published in: Annals of family medicine Vol. 22; no. 5; pp. 383 - 391
• Main Authors: Vichare, Anushree, Bodas, Mandar, Jetty, Anuradha, Luo, Qian Eric, Bazemore, Andrew
• Format: Journal Article
• Language: English
• Published: United States Annals of Family Medicine 01-09-2024; American Academy of Family Physicians
• Subjects: Adult; Beneficiaries; Cross-Sectional Studies; Ethnic and Racial Minorities - statistics & numerical data; Ethnicity - statistics & numerical data; Family medicine; Family Practice - statistics & numerical data; Female; Health aspects; Humans; Male; Medicaid; Medicaid - statistics & numerical data; Middle Aged; Minorities; Minority Groups - statistics & numerical data; Original Research; Physicians (General practice); Physicians, Family - statistics & numerical data; Surveys; United States; United States; health workforce diversity; Medicaid; racial health inequities
• ISSN: 1544-1709; 1544-1717; 1544-1717
• DOI: 10.1370/afm.3140

Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.
This descriptive cross-sectional study used 2016 Medicaid claims data from the Transformed Medicaid Statistical Information System and from 2016-2017 American Board of Family Medicine certification questionnaire responses to examine the diversity and Medicaid participation of FPs. We explored the diversity of FP Medicaid patient panels and whether they saw ≥150 beneficiaries in 2016. Using logistic regression models, we controlled for FP demographics, practice characteristics, and characteristics of the communities in which they practiced.
Of 13,096 FPs, Latine, Hispanic, or of Spanish Origin (LHS) FPs and non-LHS Black FPs saw more Medicaid beneficiaries compared with non-LHS White and non-LHS Asian FPs. The patient panels of URiM FPs had a much greater proportion of Medicaid beneficiaries from racial and ethnic minority groups. Overall, non-LHS Black and LHS FPs had greater odds of seeing ≥150 Medicaid beneficiaries in 2016.
These findings clearly show the critical role URiM FPs play in caring for Medicaid beneficiaries, suggesting physician race and ethnicity are correlated with Medicaid participation. Diversity in the health care workforce is essential for addressing racial health inequities. Policies need to address problems in pathways to medical education, including failures to recruit, nurture, and retain URiM students.