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Doctors Call for Medicaid Parity Extension


The American College of Physicians says the expiration of the Medicaid Pay Parity Program could have a significant effect on patients' ability to access primary care.

The American College of Physicians is warning that patient access to primary care physicians could be significantly curtailed if Congress doesn’t extend the Medicaid Primary Care Pay Parity program.

The program, under which the government reimburses for Medicaid patients at the same rate it uses for Medicare patients, is set to expire at the end of this year. The program first went in to place in 2013.

A bill introduced in Congress in July would extend Medicaid parity for another 2 years. However, the bill has yet to receive a vote.

“We are speaking for our patients when we ask senators and representatives to do the right thing and see that current Medicaid payment rates for primary care and immunization services are maintained,” said ACP President David A. Fleming, MD, MA, FACP, in a press release.

This week, ACP released a report outlining the problems it says would come if the extension isn’t granted. The report notes that prior to implementation of the parity program, the average Medicaid payment for primary care services was only 59% of the average payment for Medicare patients.

An ACP survey from April found 40% of pay parity program participants would accept fewer Medicaid patients if the program ended. Another 6% said they would stop taking Medicaid patients altogether if the program ends.

The report says studies have consistently shown that greater access to primary care reduces overall healthcare costs.

“It stands to reason, then, that the nation’s healthcare costs will increase, and outcomes will be poorer, if the Medicaid Pay Parity program is discontinued,” the report states. “For instance, patients enrolled in Medicaid may seek care in an emergency room if they do not have a primary care physician.”

If the cuts happen and doctors accept fewer Medicaid patients, it could offset the benefits of expanded insurance coverage under Medicaid. More than 65 million Americans are currently enrolled in Medicaid, which saw a 10% jump in enrollment from September of last year to April of 2014.

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