Experts believe that raising Medicaid physician payment rates to match Medicare rates would increase access to care for Medicaid patients.
Currently, Medicaid payments are lower than Medicare payments, making the program less desirable for small and medium-sized family practices, which often have a thin profit margin.
The American Academy of Family Physicians (AAFP) continues to press for equal payments to physicians of Medicaid and Medicare patients. Because payments are significantly lower for Medicaid patients, there is less incentive for family physicians to accept new patients. In the AAFP's 2014 Practice Profile Survey, 60 percent of family physicians accepted new Medicaid patients; 10 percent had stopped taking new Medicaid patients in the past year; and 16 percent had stopped accepting new Medicaid patients more than 12 months ago.
In a recent letter to Health & Human Services (HHS) Secretary Sylvia Burwell and Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt, AAFP Chair Dr. Robert Wergin expressed disappointment that after more than four years, CMS has yet to develop a consistent approach to measuring access to care.
"We believe CMS needs to exert oversight that will prevent reductions in access to care -- especially for Medicaid beneficiaries to their primary care physicians," he said in the letter.
Wergin pointed out that the Patient Protection and Affordable Care Act (ACA) had provided additional reimbursement to physicians for two years. During that time, availability of appointments for Medicaid patients increased. The program ended in 2015.
"States with the largest increases in availability tended to be those with the largest increases in reimbursements," Wergin said.
The AAFP will continue its efforts to ensure that patients have access to medical care through Medicaid and that payments are high enough to encourage physicians to participate in the program.
