Few Medicaid-participating primary care physicians providing longer-acting birth control methods, finds study

Medicaid beneficiaries face barriers in accessing medical care—and that includes contraceptive care. A new study finds that despite birth control being an essential health service, all primary care physicians that see them may not be offering Medicaid patients some of the most effective, longer-acting birth control methods. While nearly half (48%) of primary care physicians who treat Medicaid patients provided prescription contraception like the birth control pill, only 10% provided longer-acting methods like IUDs and implants, according to a new study published in JAMA Health Forum.

“This study is first of its kind and uses a national dataset of all Medicaid claims filed in the U.S,” Mandar Bodas, a research scientist at the GW Milken Institute School of Public Health and lead author of the study, said. “In our analysis, we found that a physician’s characteristics—including their clinical specialty, age, gender and the Medicaid expansion status of their state—were associated with both providing any contraceptive care and with the number of beneficiaries provided contraceptive care,” Bodas said.

This study suggests that ensuring access to contraceptive services among Medicaid beneficiaries may require policy and program approaches tailored to different physician specialties. For example, Bodas says that primary care doctors from certain specialties would need more training to provide the full scope of contraceptive care to their patients.

“Previous research tells us that Medicaid beneficiaries face a number of barriers to accessing primary care, and our study finds that one of those barriers is lack of access to the full range of contraceptive methods,” Julia Strasser, one of the Primary Investigators of the research project and Director of the Jacobs Institute of Women’s Health at the GW Milken Institute School of Public Health, said.

“If a patient goes to a physician who is the only provider in the area that accepts Medicaid, and that physician only provides the birth control pill but not other methods, then it’s hard to say that the patient has reasonable access to all forms of contraception,” Strasser said.

By studying the primary care workforce that provides contraceptive care to this population, the research helps shed light on important factors that predict access to these critical health services, the authors said.

The paper, “Association of Primary Care Physicians’ Individual- and Community-Level Characteristics With Contraceptive Service Provision to Medicaid Beneficiaries,” was published in JAMA Health Forum on March 17.