Slow payment appears to discourage physicians from seeing new Medicaid patientseven in states with relatively high Medicaid reimbursementaccording to a Center for Studying Health System Change report posted as a Web exclusive of the journal Health Affairs.
Center for Studying Health System Change researchers Peter Cunningham and Ann OMalley studied how 4,900 physicians in 21 states responded to not only how much they were paid by their states Medicaid program, but also by how quickly they were paid. A total of 6,600 physicians were surveyed.
Citing previous research that found that, nationally, about half of all doctors are accepting new Medicaid patients compared with more than 70% for new privately insured or Medicare patients, the authors compared how physician Medicaid participation was affected by how much and how fast they were paid by their respective state programs.
In states with higher and faster reimbursement, such as Arkansas and North Carolina, 64% of physicians were accepting new Medicaid patients. In states with high fees but slow reimbursement, such as Connecticut and Georgia, only 50.9% of doctors were taking new Medicaid patients. For states such as Rhode Island and South Carolina, with low but fast payment, 48.4% of physicians were seeing new Medicaid patients. And, in states classified as low and slow paying, such as California and Missouri, only 43.2% of doctors were seeing new Medicaid patients.
Although low fees are one of the primary reasons discouraging physicians from participating in Medicaid, other factorsincluding payment times and administrative burdenare also important, the authors concluded. In fact, the results of this study strongly suggest that higher fees will not have the desired effect on access if it takes physicians several months or longer to be reimbursed.
Medicaid reimbursement was the fastest in Kansas, averaging 36.9 days, and slowest in Pennsylvania, averaging 114.6 days. -- by Andis Robeznieks