Medicaid expansion, patient influx may result in doctor shortage

The increase in Medicaid patients under the Affordable Care Act will exacerbate the looming doctor shortage, with many current practitioners unable to take on any more patients covered by the program, according to the New York Times.

Primary care facilities and community clinics are scrambling to find enough doctors, nurse practitioners and other medical staff to cope with the anticipated influx of 9 million patients anticipated to gain access to coverage when Medicaid expansion is implemented in five weeks, the article states.

By 2015, one year after healthcare reform will take effect in the U.S., there will be a physician shortage of roughly 63,000 doctors, according to estimates from the Association of American Medical Colleges.

In California, officials say access won't be an issue, despite the fact only about 57 percent of doctors there accept new Medicaid patients, according to a study published last year in Health Affairs, FiercePracticeManagement previously reported. That number might drop even more after payments for Medicaid are cut an additional 10 percent as the expansion begins, the New York Times reported, creating a delay in care for patients who need to see a specialist, such as an ear, nose and throat doctor or an optometrist.

Although there will be an initial two-year 73 percent hike in Medicaid payment rates for primary care doctors, many believe that the increase is a temporary solution, which has led to few doctors accepting new patients covered under Medicaid. "There's been a lot of confusion and a really slow rollout," Lisa Folberg, a vice president of the California Medical Association told the newspaper, "which unfortunately mitigated some of the positive effects."

The doctor shortage issue isn't a new problem.  A June 2008 report from the Medicare Payment Advisory Commission (MedPAC) found that one-third of Medicare recipients nationwide have trouble finding primary-care physicians in Arizona, FierceHealthcare previously reported.

Foreign-trained doctors, physician assistants and nurses might help fill the gap due to the shortage, according to previous FierceHealthcare reports. In other efforts to recruit healthcare professionals to deal with an influx of Medicaid patients, New Mexico's governor asked the legislature for more than $200,000 to launch a marketing campaign to attract nurses from other states.

To learn more:
- here's the New York Times article

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