WIP 92 - Analysis of Spatial Access to Medicaid Primary Care Providers and Child Opportunity Index in Chicago, IL

Publication Number: WIP 92.7414

Alyssa Hyndman, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Jennifer Kusma Saper, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Michelle Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Lack of provider participation in Medicaid has provided a structural barrier to primary care access for children, especially in urban areas. Children who live in poverty in Chicago often reside in areas with fewer physicians that participate in Medicaid, resulting in underserved areas and limitation to access to primary care despite expansion of the Illinois Medicaid program. Following the COVID-19 pandemic, pediatric primary care well child check attendance has decreased substantially, with a greater impact on those with public insurance coverage and reported unmet social needs. Further investigation is warranted to implement interventions and influence policy changes that would most benefit Chicagoland youth.

Objective: The goal of this study is to investigate if pediatric primary care providers in the city of Chicago accept Medicaid in comparison to child opportunity index and to identify possible gaps in care.

Design/Methods: This study was approved by the Lurie Children Internal Review Board. The data collection portion of the study (July 2023 - December 2023) included identification of primary care clinics via Google search of Chicago's inner city zip codes. Available clinic websites were utilized for collection of demographics, Medicaid plan acceptance, number and types of providers, board certification status of physicians, FQHC status, and weekend hours. Medicaid acceptance was categorized into “yes”, “limited” or “no” based on the number of plans accepted. Phone calls were conducted to ensure working phone numbers and operational clinics that saw children 18 and younger.

Descriptive statistics and logistical regression analysis will be completed with odds ratio calculations using individual clinic demographic variables, density of clinics per pediatric population, and childhood opportunity index indicators. Geocoding analysis will be completed to create data visuals using childhood opportunity index and available Medicaid providers. The analysis and results will be completed between November 2024 and February 2025 with plans to submit a manuscript by April 2025.