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Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care? |
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From The Commonwealth Fund: Primary care physicians who treat a disproportionate share of black and Latino patients provide more charity care, see more patients, depend more heavily on low-paying Medicaid, and earn lower incomes than physicians seeing mostly white patients. Such practice constraints play an important role in why physicians treating large numbers of minority patients report more problems delivering high-quality care than other physicians---from spending an average of 30 percent less time per patient to having a harder time obtaining specialty care, conclude the authors of "Do Primary Care Physicians Treating Minority Patients Report Problems Delivering High-Quality Care?" The study sheds new light on pervasive racial and ethnic health disparities in the United States by looking beyond individual patient characteristics to community and physician practice resources. The study also examines how higher Medicaid payments might help physicians provide high-quality care. Using data from the 200405 Community Tracking Study Physician Survey, the authors build on research that goes beyond assessing patients' characteristics to examine how the aggregate socio-economic and insurance composition of a provider's patient base contributes to racial disparities. Most (52%) physicians examined had patient panels with less than 30 percent minorities (i.e., low-minority practices), about a third (36%) reported that 30 percent to 70 percent of their patients were black or Hispanic (i.e., medium-minority practices), and 12 percent said that minorities made up more than 70 percent of their patients (i.e., high-minority practices). Moreover, physicians in high-minority practices depended on Medicaid for more than a third of their revenue, or more than twice that of physicians in low-minority practices. When researchers modeled the likely effect of raising Medicaid payments so that they equaled Medicare payments to physicians, they found improvements on several measures, particularly for physicians with high-minority practices.
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