How Does Access to Primary Care Vary by Type of Insurance and by Rural and Urban Counties in Mississippi?

Abstract

A common assumption is that access to primary care is less prevalent in rural areas. To measure actual access to primary health care in Mississippi we telephoned primary care physician practices (general practitioner, family practice, internal medicine, OB/GYN and pediatric) in Mississippi posing as a potential new patient. To measure access, we asked for a new patient appointment with a physician varying our insurance type such as Blue Cross & Blue Shield (BC&BS), Medicare, or Medicaid health insurance. Similar to other findings, only 50 % of practices were accepting new Medicaid patients. Likewise only 64 % were accepting new Medicare patients and 78 % were accepting new BC&BS health insurance patients. However, there were significant differences across the rural-urban continuum. Those practices in urban counties were significantly less likely to accept new Medicaid patients (<50 %) versus those in the most rural counties (up to 85 %). This trend was not evident for BC&BS or Medicare insurance patients. We speculate that lower operating costs in rural areas, plus smaller patient populations, may provide the financial incentives for physicians to accept Medicaid patients. As a result, access to health care for Medicaid-insured individuals is greater in rural counties than it is in urban counties in Mississippi.