Medicaid payment increases tied to greater pediatrician participation

(Reuters Health) – – When state Medicaid programs increased physician payment rates, more pediatricians agreed to treat low-income kids covered by the health insurance program for the poor, a U.S. study suggests

Researchers examined the proportion of pediatricians accepting Medicaid before and after payments increased in 2013 and 2014 – and found gains in participation nationwide as well as in most studied states.

“When many doctors refuse to accept Medicaid patients or place restrictions on patient access to care, it becomes harder for parents to find quality physicians for their children within a reasonable geographic area,” said senior study author Dr. Andrew Racine, a researcher at Albert Einstein College of Medicine and Montefiore Health System in Bronx, New York.

“Patient needs often go unmet and necessary care may be delayed, resulting in avoidable emergency room visits and hospital admissions,” Racine said by email. “The long-term consequences include poorer outcomes for the patients and ultimately higher health care costs for the country.”

Before the payment increases, Medicaid fees for primary care services for all age groups were typically 59 percent of the amount paid by Medicare, the U.S. health program for the elderly, researchers note in Pediatrics.

An estimated 36 percent to 48 percent of U.S. children are insured by Medicaid, and kids make up 53 percent of Medicaid enrollees.

But Medicaid payment for pediatric primary care services averaged 64 percent of payment from Medicare and 53 percent of payment from private insurance before 2013, when Medicaid payments were raised as part of the Patient Protection and Affordable Care Act.

For the current study, researchers examined data from nationwide surveys of pediatricians done by the American Academy of Pediatrics that assessed how many doctors accepted Medicaid and what proportion of patients were insured by the program.

The proportion of pediatrics practices accepting at least…

Read the full article from the Source…

Leave a Reply

Your email address will not be published. Required fields are marked *