Medicaid beneficiaries pose a challenge for health plans attempting to establish Medicaid provider networks. Compared to membership in commercial health plans, Medicaid enrollees typically

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Medicaid beneficiaries often require access to greater numbers of obstetricians and pediatricians compared to commercial health plan members due to higher rates of pregnancy and childbirth among Medicaid enrollees, as well as the larger proportion of children in the Medicaid population. Additionally, Medicaid beneficiaries may face barriers to accessing care, such as transportation or lack of available providers, and so having a larger network of providers can help ensure that enrollees receive needed care.

Medicaid Beneficiaries Pose a Challenge for Health Plans Attempting to Establish