Quality of Primary Care by Race, Ethnicity and Language among Medicaid Children in California: The Role of Managed Care

Arpita Chattopadhyay, University of California, San Francisco

Using hospitalization rates for Ambulatory Care Sensitive conditions, this paper seeks to examine the racial and ethnic variation in quality of primary care among TANf-eligible Medicaid children in California. Variation in physician care quality by primary language is also examined. Results show that Hispanic and African American children have worse quality of primary care, but Asian children enjoy better quality care than white children. Given their ethnicity, however, children whose primarily language is Spanish or Asian experience much better primary care than their English speaking counterparts. Furthermore, managed care is associated with further improvements in the quality of primary care for Spanish and Asian speaking children. The increasing reliance on managed care for health care delivery by state Medicaid agencies is not likely to cause barriers to care for non-English speaking children.