New Study Links Low Medicaid Payment Rates with Healthcare Access Challenges

Research released by a national physician recruitment firm has found that individuals who are enrolled in state Medicaid programs are having greater difficulties gaining appointments with medical specialists.

The 15-city survey by staffing firm Merritt Hawkins, conducted over a five-month period in 2013, found that only 46 percent of physicians in five medical specialties – cardiology, dermatology, obstetrics-gynecology, orthopedic surgery and family practice – are accepting Medicaid.  That is a 10 percent decline from four years earlier.

An article on the study in Bloomberg BusinessWeek said the core issue is the inadequacy of Medicaid reimbursement levels.  The article quoted the administrator of an ear, nose and throat clinic in Grand Junction, CO as saying, “What they (Medicaid) pay doesn’t even come close to covering expenses.  You can’t make this up in volume.”  The article noted that, for a basic office visit at the clinic, private health insurance paid $119, Medicare paid $73 and Medicaid just $52.

As Medicaid expands its eligibility in several states, studies like this warrant careful attention as policymakers seek to ensure that coverage and access to care are synonymous.