Despite being paid more for Medicaid services under Obamacare, there was no significant change in primary care doctors participating in the program, a Monday study in the Journal of the American Medical Association found.
There was no relationship between increased reimbursement under Medicaid and the amount of patients on Medicaid doctors saw, the study found. Even when adjusting for trends such as when the increased payment went into effect, there was no positive relationship between increased payment and seeing more Medicaid patients.
Obamacare increased Medicaid reimbursement by mandating that it be on par with Medicare reimbursement. Historically, reimbursement rates for Medicaid have been lower than those for Medicare. Medicaid paid doctors only 72 percent of what Medicare paid them on average, according to a March 2017 study from the Urban Institute.
Obamacare instituted a two-year rule that reimbursement for Medicaid must be equal to Medicare for primary care physicians, which raised reimbursement rates during 2013 and 2014. Nineteen states have extended the payment increases as of 2016. (RELATED: CMS Rule Strikes Obama-Era Regulation That Pays For Third-Party Fringe Benefits Instead Of Health Care)
Under Obamacare, the majority of doctors taking Medicaid are paid on a managed care model. That means they are paid for a patient’s care overall, rather than for individual services administered to the patient. However, some doctors are still on a fee-for-service model, meaning they are charged per service provided rather than for the overall patient visit. Under Obamacare, both rates were raised, so regardless of the way doctors are reimbursed under Medicaid, they still received more payment than they did before the health care policy went into effect.
Despite little change in primary care doctors accepting Medicaid, there are more Medicaid patients thanks to state expansions under Obamacare. For states that have expanded Medicaid coverage, there was a 36.74-percent increase in beneficiaries between September 2013 and April 2018, according to Centers for Medicare and Medicaid Services data.
The study used IMS Health data from 2012 to 2015. The data included all states except Alaska and Hawaii.
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