Regional trends in perceptions of American Shoulder and Elbow Surgeons towards barriers to access for patients with Medicaid: limited perioperative service access, low patient engagement, and decreased reimbursement are regionally consistent obstacles

Among members of the ASES, the primary perceived barriers to access for patients with Medicaid remained consistent across geographic region and included reimbursement, low patient engagement in their care, and patient's ability to access perioperative services. The greatest regional disparity in perceived barriers to access for Medicaid was between the South and the Northeast in regard to implant reimbursement at surgeons' primary surgical facility. This was perceived as a barrier to access in 30% more of the Southern respondents compared to respondents from the Northeast. Further investigation into regional differences in Medicaid administration would be valuable to assess how these variances affect patient access to subspecialized shoulder and elbow care.