Where do the bulk of Medicaid beneficiaries receive their care? The distribution of the size of practices serving Medicaid beneficiaries has been largely under-examined, despite important implications for the design of effective quality improvement initiatives.

Four states — Arkansas, Michigan, New York, and Pennsylvania — participated in the Practice Size Exploratory Project (PSEP), a Center for Health Care Strategies initiative funded by the Robert Wood Johnson Foundation. CHCS provided the participants with technical assistance in assessing practice-level data for their Medicaid managed care populations to address questions about whether Medicaid beneficiaries disproportionately receive care from small-sized medical practices.

The project’s goals were to describe the distribution of practice settings (i.e., solo/small, medium, large, federally qualified health center) serving the Medicaid population in the four states, and to explore the relationship between practice setting and performance on HEDIS quality-of-care measures. The initiative’s findings were disseminated broadly to inform quality improvement models for small-practice settings.