Doctors Just Say No to New Medicaid Patients
Medicaid is supposed to be a safety net. Yet, one in three doctors in the United States doesn't accept new patients who are covered by Medicaid, the federal program that is expected to enroll millions more low-income people as part of health care reform, according to a new government study, reported on by the Wall Street Journal.
In a sample of more than 4,300 doctors, 31 percent said they wouldn't accept Medicaid patients, wrote economist Sandra Decker of the National Center for Health Statistics in an article in the journal Health Affairs. What's the turnoff? Most of the doctors pointed to the low reimbursement rate from Medicaid.
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On the other hand, 18 percent of doctors said they weren't taking new patients with private insurance, and 17 percent said they weren't taking new patients who had coverage through Medicare.
The study is eye opening. With much brouhaha over this summer's Supreme Court decision that effectively gave states the chance to opt out of the expansion of Medicaid, it's not clear which way they will go, and even if they go for expansion, what good will it do if doctors essentially hang out a no Medicaid patients wanted sign on their doors?
According to the Wall Street Journal report, the study's researchers found a big variation among states. For example, in New Jersey, nearly 60 percent of doctors said they wouldn't accept new patients with Medicaid coverage. But in Wyoming, almost all doctors did accept Medicaid patients. What seems to be the difference? Smaller practices and doctors in metropolitan areas were less likely than other doctors to take new Medicaid patients.
This study isn't the first to show such results. According to a recent survey from the Texas Medical Association, Texas physicians available to treat new Medicaid patients have plummeted from 42 percent in 2010 to 31 percent - an all-time low.
However, there is reason to be hopeful. There are provisions in the health law that provide temporarily higher Medicaid reimbursements in 2013 and 2014 that might help, but the question though, is what happens beyond that?
"Higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients," Decker wrote in her article. But the temporary nature of planned increases "could mitigate their impact."
The health care debate is far from over.
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