Physicians (not) accepting new patients with Medicaid

Austin alerted me to some preliminary results from Jackson Healthcare’s Physician Practice Trends Survey:

Currently, 36 percent of physician respondents reported being unable to accept new Medicaid patients. Twenty-six percent of physicians said they do not see Medicaid patients at all.

Top five physician specialties least likely to accept new Medicaid patients:

  • Dermatologists (34 percent)
  • Endocrinologists (36 percent)
  • Plastic Surgeons (36 percent)
  • Internal Medicine: General (42 percent)
  • Physical Medicine & Rehabilitation (43 percent)

Top five physician specialties most likely to accept new Medicaid patients:

  • Pediatric Subspecialists (95 percent)
  • Pathologists (90 percent)
  • Radiologists (86 percent)
  • Anesthesiologists (83 percent)
  • General Surgeons (81 percent)

Now those who want to panic will note that more than one third of physicians will not accept new Medicaid patients. Coupled with the fact that something like 16 million more people will have Medicaid under the ACA, and that looks like a recipe for disaster. But there are a few caveats you need to remember:

  1. Medicaid currently under-reimburses. If the ACA holds, though, reimbursement rates will look more like those seen in Medicare, which is much better.
  2. Medicaid is mostly a program for children and pregnant women. Therefore, it’s most important that pediatricians and Ob/Gyns not be on that denial list. They’re not. It’s less concerning if docs who don’t see many Medicaid beneficiaries don’t accept new ones.
  3. There are lots of docs who don’t accept new patients with private insurances. Networks by definition deny you acceptance if you don’t have the right private insurance. But you never see articles complaining that this is a reason to hate private insurance.

Regardless, I don’t dispute the findings. But when docs won’t accept an insurance because it can’t pay enough, you fix it by figuring out a way to pay more. That requires more money, not cuts.


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