Still Shunning Medicaid Patients

Hello. I’m Dr Charles Vega, and I am a clinical professor of family medicine at the University of California at Irvine. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

Physician participation in the Medicaid program was largely unaffected by Affordable Care Act (ACA)-mandated payment increases to primary care providers or the expanded access programs established in some states. This conclusion comes from data collected between 2012 and 2015.

Compared with family physicians, pediatricians were more likely to report accepting new Medicaid patients, and internists were less likely. While the ACA resulted in a 20% increase in adult Medicaid patients, these patients remained concentrated among a small number of primary care physicians, with 60% of them treated by 20% of the physicians who participated in Medicaid.

The fact that most primary care physicians made little or no change to their Medicaid participation despite the influx of millions of newly Medicaid-covered patients may be a reflection of low reimbursement rates, administrative burdens, the temporary nature of the reimbursement increases, or other factors that make participation difficult or unappealing.

But whatever the reason, physicians and policymakers need to tackle this together if we’re going to address the health concerns of this vast population of adults.

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