Many Physicians are not taking Medicaid
An analysis from HealthPocket raises the specter that individuals who obtain health coverage under expanded Medicaid starting in 2014 will have to dig to find a clinician who will treat them.
At the same time that many states are increasing their Medicaid rolls under the Affordable Care Act (ACA), only 43 percent of physicians report that they currently accept Medicaid patients, HealthPocket said last week in a news release.
In addition, only 20 percent of physician assistants (PAs) and nurse practitioners (NPs), who already are paid lower reimbursement rates by the nature of their training, report that they accept Medicaid. They have been viewed by many as a potential solution to the shortage of primary care physicians and healthcare capacity. Their Medicaid acceptance may be underreported because some PAs and NPs may work under a Medicaid-accepting physician, the analysis said.
The acceptance rates raise the question of whether Medicaid expansion will insure more Americans, who will then face a significant shortage of practitioners to go to for their care, said Kev Coleman, head of research and data at HealthPocket, which compares and ranks health plans, in the news release.
Historically, Medicaid payments to physicians have been lower than those from both private insurance and Medicare for the same service. On average, Medicaid pays doctors only 66 percent of the amount Medicare pays for the same service, according to a December 2012 study by the Kaiser Family Foundation. The result of this lower reimbursement rate is a smaller pool of physicians who are willing to accept Medicaid, HealthPocket noted in the news release.
The ACA includes provisions to raise the reimbursements rates of Medicaid compared to Medicare and other plans, but those have not fully been established and offer only a temporary two-year increase.
“Ensuring there are sufficient healthcare providers available to the newly insured—even those with private insurance—is a major public health challenge right now,” Coleman said in the release. “But if the current Medicaid acceptance rates hold true for 2014, timely access to care for those relying on Medicaid is likely to become more difficult as enrollees increase for an already inadequate pool of doctors.”
HealthPocket also compared rates in the five cities with the highest average household income to the five cities with the lowest to examine whether an area’s income influenced Medicaid acceptance. HealthPocket found that the richest and poorest cities had similar Medicare acceptance rates on average despite their differences in income. Both groups had one city well below the national average for Medicaid acceptance. Among rich cities, Washington, D.C. was the lowest, with only 31 percent of healthcare providers documented as accepting Medicaid. Among the poorest cities, Detroit was the lowest, having the same acceptance rate as D.C.
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