TY - JOUR
AU - Graves, Janessa M.
AU - Abshire, Demetrius A.
AU - Undeberg, Megan
AU - Forman, Laura
AU - Amiri, Solmaz
PY - 2020
TI - Rural-Urban Disparities in Access to Medicaid-Contracted Pharmacies in Washington State, 2017
T2 - Preventing Chronic Disease
JO - Prev Chronic Dis
SP - E92
VL - 17
CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2 - INTRODUCTION Community retail pharmacies offer multiple public health services to meet the health care needs of medically underserved rural communities. Many rural residents are enrolled in Medicaid insurance, and it is important that pharmacies contract with Medicaid to meet the health care needs of these people. The objective of this study was to evaluate disparities in access to Medicaid-contracted pharmacies across the rural-urban continuum in Washington State. METHODS We linked data on licensed community retail pharmacies in Washington State in 2017 to lists of state Medicaid-contracted pharmacies. We classified pharmacies as being located in small rural, large rural, suburban, and urban areas by using rural-urban commuting area (RUCA) codes. We evaluated the likelihood of zip code-level access to at least 1 pharmacy that was contracted with a Medicaid insurance plan across the rural-urban continuum by using descriptive statistics and modified Poisson regression models, adjusted for zip code-level community characteristics. RESULTS Of 1,145 pharmacies in our study sample, 8.4% (n = 96) were not contracted with a Medicaid plan. Compared with urban core zip codes, small rural zip codes (adjusted relative risk [ARR] = 0.64; 95% CI, 0.46-0.91) and large rural zip codes (ARR = 0.68; 95% CI, 0.49-0.95) were significantly less likely to have access to a Medicaid-contracted pharmacy. Suburban zip codes did not differ significantly from urban core areas in their access to Medicaid-contracted pharmacies. CONCLUSION In Washington State, the likelihood of access to a Medicaid-contracted pharmacy decreased significantly as rurality increased. Policy efforts should aim to improve access for Medicaid enrollees, especially those outside urban centers.
SN - 1545-1151
UR - https://doi.org/10.5888/pcd17.200066
DO - 10.5888/pcd17.200066
ER -
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