Study: Doctors Dropping Medicaid

Published August 1, 2009

The number of doctors accepting Medicaid patients has dropped significantly in the past five years, a new study shows.

In a study of 15 metropolitan areas, researchers for Merritt Hawkins & Associates, a Texas-based physician recruiting and consulting company, found 55.4 percent of physicians are currently accepting patients covered by the taxpayer-funded, government-administered health insurance program for low-income Americans. Many providers have walked away from the program in recent years, the study reports.

Of the Atlanta dermatologists surveyed in 2004, for example, 100 percent accepted Medicaid patients. By 2009 that share had dropped to zero. In Philadelphia, cardiologists’ acceptance of Medicaid dropped from 80 percent to 8 percent between 2004 and 2009.

“The problem with Medicaid is that it pays so poorly,” said Merritt Hawkins & Associates spokesman Phil Miller. “In some cases [doctors] just cannot afford to see Medicaid patients. If you’re a doctor and you’ve got more patients than you can handle, you might drop certain categories of patients if you’re losing money on those.”

Medicaid No Model

The study’s authors presented their findings as evidence health care reform should not be based on expanding current government-run programs or creating new ones.

“Though a form of health care coverage, the survey indicates Medicaid does not guarantee access to physicians in many cases,” the study’s authors wrote. “Therefore, plans to expand Medicaid, or to create other forms of government-supported health care insurance that reimburse physicians below their costs, may not have the effect of increasing access for some patients.”

Perverse Incentives

The reason, said Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute, lies in simple economic principles.

“In some places, such as Massachusetts, where the waiting times are severe, they’ve increased the number of insured patients, but there aren’t enough doctors to go around, and physicians just don’t see the value in losing money on every patient they see,” Scandlen said.

“Though rates of reimbursement vary by state, Medicaid typically does not cover overhead expenses for a visit to the doctor’s office,” noted Dr. Mario Motta, president of the Massachusetts Medical Society.

As a result, Scandlen explained, “Many people who could qualify for Medicaid don’t apply for it, because so many doctors don’t accept it and also because of the stigma associated with accepting government handouts.

“All of that would be eliminated if the government simply made the money available and people could get private coverage,” Scandlen added.

Whitney Stewart ([email protected]) writes from Minnesota.

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