The healthcare reform law will worsen the supply of primary care physicians treating Medicaid patients because temporary increases in pay would not attract enough physicians to meet the huge expansion in Medicaid recipients, according to a study by the Center for Studying Health System Change.
Starting in 2014, the reform law will add about 16 million people to the Medicaid rolls by expanding Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level. To entice more physicians to treat these patients, the law also raises Medicaid reimbursement rates to Medicare levels for certain services. But the raise only lasts from 2013-2014, and then Medicaid rates revert to previous levels.
The study concluded that the temporary reimbursement increases would have little impact in states that currently have fewer primary care physicians in Medicaid, precisely the states where more physicians are needed in Medicaid. Those states, mainly in the South and West, tend to pay Medicaid rates close to or exceeding Medicare levels, so the raise would not have much meaning.
Peter J. Cunningham, PhD, the study's author, said the flood of 16 million more people into Medicaid would overwhelm the paltry numbers of physicians to treat them. "Growth in Medicaid enrollment in much of the country will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients resulting from increased reimbursement," he wrote.
Avik Roy, who writes the "Apothecary" blog at Forbes, noted that it is unlikely that states or the federal government would extend the temporary Medicaid fee hikes beyond 2014 due to continuing budgetary pressures.
The law boosts Medicaid eligibility levels to individuals with incomes of up to $14,400 and families of four with incomes just under $30,000. Mr. Roy wrote that instead of raising coverage limits, state Medicaid programs should be allowed to focus on "fully funding care for the truly needy" through federal waivers. "[I] oppose spending more money that we don’t have," he wrote.
Read more coverage of Medicaid reimbursements:
- HHS to Clarify Rules on Medicaid Payments to Providers
Starting in 2014, the reform law will add about 16 million people to the Medicaid rolls by expanding Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level. To entice more physicians to treat these patients, the law also raises Medicaid reimbursement rates to Medicare levels for certain services. But the raise only lasts from 2013-2014, and then Medicaid rates revert to previous levels.
The study concluded that the temporary reimbursement increases would have little impact in states that currently have fewer primary care physicians in Medicaid, precisely the states where more physicians are needed in Medicaid. Those states, mainly in the South and West, tend to pay Medicaid rates close to or exceeding Medicare levels, so the raise would not have much meaning.
Peter J. Cunningham, PhD, the study's author, said the flood of 16 million more people into Medicaid would overwhelm the paltry numbers of physicians to treat them. "Growth in Medicaid enrollment in much of the country will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients resulting from increased reimbursement," he wrote.
Avik Roy, who writes the "Apothecary" blog at Forbes, noted that it is unlikely that states or the federal government would extend the temporary Medicaid fee hikes beyond 2014 due to continuing budgetary pressures.
The law boosts Medicaid eligibility levels to individuals with incomes of up to $14,400 and families of four with incomes just under $30,000. Mr. Roy wrote that instead of raising coverage limits, state Medicaid programs should be allowed to focus on "fully funding care for the truly needy" through federal waivers. "[I] oppose spending more money that we don’t have," he wrote.
Read more coverage of Medicaid reimbursements:
- HHS to Clarify Rules on Medicaid Payments to Providers