Declining Medicaid fees to doctors linked to decreased patient access to primary care appointments

Doctor putting money in pocket
Lower Medicaid fees for doctors translate to less availability of primary care appointments for patients, according to research published in JAMA Internal Medicine. (Getty/Niyazz)

When Medicaid pays doctors less money for the care they provide, new patients have limited access to primary care appointments, according to a new study.

While previous research found that when there is an increase in Medicaid fees paid to doctors and other clinicians, Medicaid patients can more easily schedule appointments with primary care doctors, the latest study published in JAMA Internal Medicine indicates the opposite happens when fees go down.

Researchers at the University of Pennsylvania found that higher Medicaid fees in 2014, brought about under the Affordable Care Act, were linked with increased primary care appointment availability for new Medicaid patients, but wondered about the impact since most states have returned to lower fee levels.


Key Realities Pushing Healthcare Into a Digital Future

Paper forms, contracts, and documents are the quicksand that bogs down both patient care and provider business. However, that does not have to be the case. Download this whitepaper to learn the three key realities that are pushing healthcare past paper-based processes and into a digital, more streamlined future.

Perhaps it should have come as no surprise then that when Medicaid pays doctors less, patients have less access to care. “As funding declines it threatens the breadth of provider participation in Medicaid,” senior author Daniel Polsky, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, told Reuters.

In the study, trained callers posed as new patients and called physician practices in 10 states to request a patient appointment. In total, they made 12,092 calls. In 2016, when Medicaid fees had returned to lower levels, researchers found a substantial decrease in appointment availability compared to 2014 data.

While Medicaid enrollment growth is slowing down, spending growth is expected to climb in the coming year, according to a survey of state Medicaid directors.

Suggested Articles

Specialty drugs made up 1% of prescriptions for employers but accounted for 40% of total drug spending last year, an analysis found.

A collaboration between California payers and providers yielded millions in savings and prevented thousands of unneeded ER visits and admissions. 

Physicians certified by the American Board of Internal Medicine will soon have a new option that takes some of the pain out of MOC.