Who is going to care for all those Medicaid patients?

How important was the passage of the Patient Protection and Affordable Care Act for primary care physicians (PCPs)? Consider this: The healthcare reform measure extended Medicaid eligibility to virtually everyone under age 65 up to 133% of the federal poverty level ($14,484 for individuals and $29,726 for a family of four in 2011). That means about 16 million more people-mostly adults-will gain Medicaid coverage, according to the Congressional Budget Office. 

Where will these newly-eligible Medicaid patients turn for primary care? That’s the  issue examined by the Kaiser Commission on Medicaid and the Uninsured in an April issue paper. The authors predict that the PCPs most willing to accept new Medicaid patients are those already serving Medicaid patients disproportionately, compared to other PCPs. Even assuming these PCPs expand their Medicaid service, however, additional PCPs will be needed to ensure access to primary care beginning in 2014.

Other key findings of the survey of 1,460 PCPs: 

• The PCPs most willing to see new Medicaid patients work in lower-income areas and are more likely to practice in hospital-based settings and community health centers.

• The majority of PCPs most willing to accept new Medicaid patients use health IT for core patient care purposes.

• The most willing PCPs often have critical patient services available at their practices, such as interpreter services and patient educators.

• Willing PCPs cite inadequate access to specialists and time for patient care as constraints.