Dead Last

3773 private practice primary care pediatricians were surveyed about their participation in their state's Medicaid program.  Nationwide, 54.6% of pediatricians would accept all state Medicaid patients who sought care at their office; some states (like Wyoming, North Dakota, and South Dakota) had private practice pediatrician participation rates of 95% or better in their state Medicaid programs.

Ranked at the bottom for Medicaid participation were Tennessee's private pediatricians.  In the survey, only 19.6% of pediatricians indicated their willingness to see all children with TennCare.  Even correcting for pediatricians who were not taking new patients in general, Tennessee still came in dead last.

Tennessee pediatricians, like their counterparts nationally, identified concerns about paperwork as a barrier to participating in TennCare.  The authors of the study also found a correlation between poorer reimbursement and decreased physician participation. 

One reason why Tennessee pediatricans might score so low relates to one of the peculiarities of TennCare as a Medicaid program: the sheer number of managed care organizations (MCOs) in the program, and the historical instability of those programs.  For a pediatrician to self-classify as "full Medicaid participation" during the survey period, he or she would have to be credentialed by eleven different TennCare plans, some of which would be outside of his or her geographic area, and some of which were already in financial receivership.

Source: Steve Berman, Judith Dolins, Suk-fong Tang and Beth Yudkowsky. "Factors That Influence the Willingness of Private Primary Care Pediatricians to Accept More Medicaid Patients." Pediatrics 2002;110;239-248.