Study: Enrollment in Medicaid To Outpace Primary Care Doctors
In the years ahead, the growth of Medicaid beneficiaries likely will outpace the increase in primary care physicians available to treat them, particularly in the southern and mountain west regions of the U.S., according to a new study released last week, HealthLeaders Media reports.
The study, conducted by the nonpartisan Center for Studying Health System Change, was funded by the Robert Wood Johnson Foundation.
Reform Law To Expand Medicaid Eligibility
The increase in Medicaid beneficiaries will be driven in part by the health reform. Under the law, Medicaid in 2014 will expand to include all U.S. residents whose annual incomes are less than 133% of the federal poverty limit, or $29,327 for a family of four.
Health care providers' Medicaid payment rates will be increased to 100% of Medicare rates in 2013 and 2014 for some services to encourage more providers to accept Medicaid patients.
Study Details, Findings
For the study, researchers analyzed survey responses from more than 4,700 physicians, 1,748 of whom identified themselves as practitioners in general internal medicine, family medicine or general pediatrics.
Researchers also used data from the Health Resources and Services Administration Area Resource File to categorize states into three groups -- low-, medium- and high-primary care physician states -- based on the ratio of physicians to non-elderly residents in 2008.
They determined that 25% of U.S. residents lived in low-primary care physician states, 50% in medium-primary care physician states and 25% in high-primary care physician states.
The study also found that the supply of primary care physicians varies significantly by region, with most physicians serving the mid-Atlantic and Northeast regions and the fewest serving the South and mountain west areas. As a result, researchers found:
- The temporary increase to Medicaid payment rates will not make much of difference in states that experience the largest enrollment increases;
- The enrollment increase will make a minimal difference in states with fewer Medicaid providers because many of those states already provide primary care reimbursements at rates that are close to or exceed 100% of Medicare; and
- The geographic differences among primary care physicians who are willing to treat Medicaid beneficiaries does not matter significantly because the geographic differences in physicians' acceptance of Medicaid patients reflects the differences in physician supply.
According to HealthLeaders Media, the study is limited because it considers the two-year Medicaid reimbursement increase permanent.
Therefore, the estimates of the effects on the increases on primary care physicians' propensity to accept new Medicaid patients might be overstated (Commins, HealthLeaders Media, 3/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.