Study: Low reimbursements keep doctors from accepting new Medicaid patients

August 22, 2012

Nearly one-third of you aren't accepting new Medicaid patients, but increasing Medicaid reimbursement rates to Medicare levels could go a long way toward overcoming that reluctance, according to a new report.

Nearly one-third of you aren’t accepting new Medicaid patients, but increasing Medicaid reimbursement rates to Medicare levels could go a long way toward overcoming that reluctance, according to a new report.

Sandra Decker, an economist with the National Center for Health Statistics, used data from the 2011 National Ambulatory Medical Care Survey Electronic Medical Records Supplement to study, on a state-by-state basis, the percentage of physicians nationwide accepting new patients. She found that, when adjusted for all variables, 64.7% of primary care physicians (PCPs) accepted Medicaid patients in 2011, whereas 71.7% of doctors in all other specialties accepted them. Decker reports her findings in an article in the August issue of the journal Health Affairs.

After controlling for other factors, however, Decker found that the acceptance rates among all physicians for new Medicaid patients were higher in states with greater Medicaid-to-Medicare fee ratios. On average, increasing the ratio by 10 percentage points raised the acceptance rates of new Medicaid patients by four percentage points. Consequently, equalizing Medicaid reimbursement rates with those of Medicare is predicted to increase the acceptance rate of new Medicaid patients among all doctors from its current average of about 70% to 78.6%-much closer to the acceptance rate for new patients covered by Medicare (83%) and those with private insurance (81.7%.) 

Among just PCPs, the study predicts, raising Medicaid reimbursement levels to match those of Medicare would increase the acceptance of Medicaid patients from its current level of 64.7% to 71.7%.

The study found that New Jersey had the lowest percentage of physicians (40.4%) accepting new Medicaid patients, followed by California (57.1%) and Florida (59.1%). The highest acceptance rates were in Wyoming (99.3%), Minnesota (96.3%), and North Dakota (94.6%).

Decker notes that under the Affordable Care Act, Medicaid reimbursement rates will increase to 100% of Medicare rates in 2013 and 2014, suggesting that physicians’ acceptance of new Medicaid patients will increase as well, at least for those 2 years.

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