One in Three Doctors Did Not Take New Medicaid Beneficiaries Last Year

Nearly one in three physicians surveyed by CDC said they did not accept new Medicaid patients in 2011, primarily because of the program's low reimbursement rates, according to a report published Monday in the journal Health Affairs, the Wall Street Journal reports (Radnofsky, Wall Street Journal, 8/6).

Report Findings

For the report, economist Sandra Decker of the National Center for Health Statistics at CDC surveyed 4,326 physicians nationwide on whether they would accept patients in the federal health care program. Decker found that 31% would not accept new Medicaid patients (Kliff, "Wonkblog," Washington Post, 8/6).

By comparison, 18% of respondents said would not accept new patients with private insurance and 17% said they would not accept new Medicare beneficiaries (Wall Street Journal, 8/6).

Decker found that even when respondents were categorized as specialists and primary care providers, the lower acceptance rate of Medicaid patients remained ("Wonkblog," Washington Post, 8/6).

Meanwhile, physicians with smaller practices and those in metropolitan areas were less likely to accept Medicaid patients, compared with other physicians (Wall Street Journal, 8/6).

Correlation With Medicaid Payment Rates

According to the Washington Post's "Wonkblog," Decker also found a positive correlation between the number of physicians that accepted new Medicaid patients and the amount that states paid them for seeing Medicaid beneficiaries.

For example, in largely rural states like Alaska and Wyoming, where Medicaid reimbursements are 50% higher than for Medicare, most physicians said they would accept Medicaid patients. In New Jersey, where Medicaid reimbursements are lowest, just 30% of physicians said they would accept new patients.

Decker noted, "Prior evidence suggests that physicians' acceptance of Medicaid patients will increase as Medicaid payment rates increase," citing the federal health reform law's temporary boost to Medicaid reimbursements in 2013 and 2014, when Medicaid is scheduled to expand under the law.

As a result, the participation rate could rise to 78.6%, an 8.6% increase over the 2011 level, Decker suggested ("Wonkblog," Washington Post, 8/6). However, she noted that the temporary nature of the rate increases "could mitigate their impact" (Wall Street Journal, 8/6).