Thursday, July 31, 2014

Medicaid Iceberg Ahead

One of the key provisions of Obamacare involves Medicaid expansion. But then SCOTUS
through a wrench in the works making expansion optional. The result, 24 states said "no" to expansion, gumming up the works.

And now this .........
Just six states and the District of Columbia will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors, which was a key provision of the Affordable Care Act (Obamacare) intended to make sure millions of low-income people enrolling in the expanding insurance program have access to a physician.
MedPage Today

What happens in the other states?
The other 42 states will let the Medicaid pay rates revert back to their 2012 levels.
Is that a bad thing?
Medicaid fees for primary care increased in 2013 and 2014 to the same amount paid under Medicare. While Medicaid fees vary by state, the change meant an average 73% pay increase nationally
When states go back to 2012 levels that translates into a 58% reduction in PCP fees paid by Medicaid.

A doc that received $100 for a Medicaid patient in 2012 saw that amount increase to $173 in 2014. Going back to 2012 levels is a 58% reduction in fees.
Physician groups, while pleased with the extra funding, have said for years that the 2-year cap would limit its impact on persuading more doctors to treat Medicaid patients. Still, they worry about what happens when the short-lived pay raise goes away in most states.
I suppose we will find out in 2015 if there will be a wholesale dumping of Medicaid patients or not.

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