The geographic distribution of disability-accessible offices of Medicaid Managed Care plan physicians in Los Angeles County

This paper examines the geographic distribution of primary care offices containing disability accessible exam equipment in Los Angeles County. The research aim was to determine whether accessible offices are distributed throughout the county, or clustered in a few locations. For reasons of equality and issues of transportation, location of accessible health providers is an accessibility issue. We analyzed data from 2096 walk-through accessibility audits of Medicaid participating physicians’ offices conducted 2013-2016, with zip codes identifying location. Audits were performed by Medicaid managed care plans using an 86-item tool based upon ADA Accessibility Guidelines (ADAAG). Staff assessed accessibility as part of state-required Facility Site Reviews of plans’ primary care physicians’ offices. We examined the presence of height-adjustable exam tables, accessible scales, lifts, and toilet room accessibility by zip code. Our analysis finds that less than half (47.3%) of LA County zip codes contain at least one office with a height adjustable exam table; 31% had an accessible weight scale; and 15.9% a patient lift. For toilet rooms, rated by percent of accessible features present, all but 16.7% of zip codes had at least one medical office compliant on 70-100% of elements. Within a zip code there mostly was a single site with the equipment or accessible toilet room. Mapping the data showed no definite patterns. The dispersal of accessible locations suggests that patients with disabilities may not find an accessible site close to home. Location needs to be considered when implementing incentive measures to increase the disability accessibility of medical practices.