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Home / News & IndustryManaged Care Insight and Analysis
Updated: July 22, 2008
Physicians Treating More Minority Patients Earn Less

Primary care physicians treating a disproportionate share of black and Latino patients typically earn less, see more patients, provide more charity care, treat more Medicaid patients and receive lower private insurance payments, according to a national study funded by the Commonwealth Fund.

These same physicians also reported more problems providing high-quality care, ranging from inadequate time with their patients to difficulty obtaining specialty care.

Conducted by researchers at the Center for Studying Health System Change (HSC), the study sheds new light on the 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 examined how higher Medicaid payments might help physicians treating mostly minority patients provide high-quality care and reduce racial and ethnic disparities.

"The findings indicate that the lower resources flowing to physicians treating more minority patients are associated with racial and ethnic disparities," said HSC Senior Researcher James D. Reschovsky, coauthor of the study with HSC Senior Researcher Dr. Ann S. O’Malley.

"Raising Medicaid payment rates, along with efforts to increase insurance coverage or otherwise increase resources flowing to physicians treating low-income and minority patients, could reduce disparities," Reschovsky said.

"The findings indicate that physicians who treat mostly minorities face challenges in delivering high-quality care. However, it also points to solutions that can reduce racial and ethnic disparities while improving healthcare access, quality and efficiency for everyone," said Commonwealth Fund Assistant Vice President Dr. Anne C. Beal. "In addition to increasing Medicaid payment levels, other efforts such as quality reporting and financial incentives for improving care, particularly through Medicaid, could also reduce disparities and help move the U.S. toward a high performance health system."

The researchers first identified physicians in low-, medium- and high-minority practices — those whose patient panels were less than 30 percent, 30-70 percent, and greater than 70 percent black or Latino, respectively.

About 52 percent of primary care physicians reported having patient panels with less than 30 percent minorities, 36 percent reported 30-70 percent of their patients were minorities, and 12 percent reported minorities constituted more than 70 percent of their patients, confirming previous research showing that relatively small numbers of physicians treat a disproportionately large share of minority patients.

The study also confirmed previous research showing well-established associations among greater minority presence, less insurance coverage and lower incomes.

In 2004-05, physicians in high-minority practices were located in areas with lower median incomes and higher uninsurance rates, according to the study.

Moreover, physicians in high-minority practices received more than a third of their practice revenue from Medicaid, compared with 13 percent for physicians in low-minority practices.

The study also found that 35 percent of physicians in high-minority practices reported patients’ inability to pay was a major barrier to providing high-quality care, compared with 23 percent of physicians inlow-minority practices.

The study was published as a Web Exclusive in the journal Health Affairs.

Address: Center for Studying Health System Change, 600 Maryland Ave. SW, #550, Washington DC 20024; 202.484.5261, www.hschange.org.


  This article was taken from:
The Executive Report on Physician Organizations

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