Pediatricians Participating in Medicaid-Reply

In Reply. —The data from Dr Fox and Mr Phua are of interest because they reflect the effects of actual increases in Medicaid payments on obstetricians' participation in Medicaid. Although the increase in payments stemmed declining participation rates, they found, as we did, that the overall effect of increased payments on participation was modest. The second North Carolina Pediatric Society survey points up how different approaches to measuring participation in Medicaid may yield different results. This survey differed somewhat from ours in that it was sent only to pediatricians who were members of the pediatric society, a different definition was used to determine if pediatricians were in active practice, the findings regarding the relationship of Medicaid payments to participation were not controlled for other factors that may influence physicians' decisions to participate in Medicaid, and the survey asked what physicians would do in response to increased payments rather than assessing