Community Health Clinics Struggle to Find Specialty Care for Medicaid Patients

April 1, 2019 | Strategic Insights for Ambulatory Care


​Most community health centers report difficulty obtaining new-patient specialty visits for Medicaid patients, but some have enhanced their access to specialists by entering into referral agreements, using appointment reminder systems, and participating in data exchange and other community-based initiatives, according to an article published in the March 2019 issue of the American Journal of Managed Care. The researchers surveyed medical directors at 361 community health centers and found that almost 60% reported difficulty accessing specialty care. Common barriers to specialty care include low Medicaid payment rates for specialists (reported by 78% of respondents), a limited number of Medicaid managed care organization networks accepting new patients (69%), and challenging administrative requirements for accessing specialist consultation (49%).

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