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The Dynamics of Rationing Outpatient Subspecialty Care for Children Covered by Medicaid 9_29_11
![The Dynamics of Rationing Outpatient Subspecialty Care for Children Covered by Medicaid Joanna Bisgaier, MSW, PhD & Karin V. Rhodes, MD, MS Table 1: Semi-structured Questions Used on Interview Guides Table 2: Selected provider quotations regarding appointment assignment decisions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Results ,[object Object],Conclusions ,[object Object],[object Object],Policy Implications ,[object Object],[object Object],[object Object],Background The purpose of this study was to understand strategies currently in use to ration outpatient appointment slots for pediatric subspecialty care by insurance status. Objective ,[object Object],[object Object],[object Object],[object Object],[object Object],Methods [Orthopedic surgeon] “I do get a decent percentage of [Medicaid-enrolled] patients who have been refused care at other facilities…because they just can’t find another doctor, so then I’m happy to see them.” [Developmental pediatrician] “…And we prioritize kids based on geography. That is, if they live across the street from our outpatient activities at [street], they come to [street].” [Adolescent medicine (PCP)] “I personally need to call. And it has to be me and not a nurse or a resident; it needs to be attending to attending, so it takes a huge amount of time to get some of these specialists to see the patients. And it’s almost a favor to me that they’re doing it….” [Neurologist] “I think the hospital made a policy of providing slots… - for physicians [PCPs] that were on a preferred list if you will. I mean that were affiliated with the hospital.”](https://image.slidesharecdn.com/rhodeskarinthedynamicsofrationingoutpatientsubspecialitycareforchildren-110929114445-phpapp02/85/the-dynamics-of-rationing-outpatient-subspecialty-care-for-children-covered-by-medicaid-92911-1-320.jpg)
