Thursday, March 17, 2011

More Access Problems Ahead for Medicaid Patients

If you hadn’t seen it already, I wanted to point out a very interesting study released by the Center for Studying Health System Change regarding access to primary care physicians for the millions of Medicaid patients newly eligible for that program due to the health care law. The study’s main findings:

  • “States with the smallest number of primary care physicians overall – generally in the South and Mountain West – potentially will see the largest increases in Medicaid enrollment.”
  • While the health care law provides an increase in Medicaid primary care reimbursement rates for 2013 and 2014 (and those two years only), “the reimbursement increases will have much less impact in states with a relatively small number of primary care physicians accepting Medicaid patients now, because many of these states already reimburse primary care at rates close to or exceeding 100 percent of Medicare” reimbursement rates.
  • Due to both of the above factors, “growth in Medicaid enrollment” in states with fewer primary care physicians “will greatly outpace growth in the number of primary care physicians willing to treat Medicaid patients.”  In other words, a Medicaid card will NOT mean access to care in many cases.

The study also found that less than 42 percent of physicians are accepting all or most new Medicaid patients – a rate less than half that of individuals with private insurance.  And, as outlined above, the reimbursement increases in primary care (even if extended beyond 2014, at a significant budgetary cost) won’t solve many of the underlying reasons why physicians won’t accept Medicaid – factors that frequently have as much to do with paperwork, bureaucracy, and long delays obtaining payment than the reimbursement payment levels themselves.

The health care law did little to reform a broken Medicaid program – choosing instead to dump 20 million or more new enrollees in an unsustainable program in dire need of transformation.  This study provides yet another indication of the access problems many Americans will face as a result.