Facilitating access to family planning services for racial and ethnic minority populations through private clinician providers

There continue to be disparities in the gains made in recent years in reducing unintended pregnancies across race/ethnic groups. Lack of insurance, lower incomes, and language limitations combine to create barriers against access to effective forms of contraception. Over twenty states provide enhanced access to family planning services through 1115 Medicaid family planning waivers. Traditionally, these publicly funded family planning services have been provided by governmental and non-profit organizations. One innovative feature of California's family planning waiver, Family PACT, is the creation of a broad provider network which includes private clinician providers such as physician groups, solo practitioners, and certified nurse practitioners among other private entities. An analysis of provider and client enrollment data shows that private providers are more likely to be physically located within specific communities of color and to serve a greater proportion of non-English speaking clients than public providers. Over the last five years, the program has increased the number of African Americans served by 15% and the number of Asian clients by 40%. Private providers serve clients with larger family sizes (2.8 vs. 2.1), higher parity (1.4 vs. 0.8), and more clients who report their primary language as Spanish (74% vs. 37%). The inclusion of providers who can meet the needs of a culturally and linguistically diverse population is thus a crucial element towards increasing access to reproductive health care and reducing unintended birth rates across racial/ethnic groups.