Most of the physicians who responded to the OSMA online survey (90%) said they were already seeing Medicaid patients before the pay increase. Nearly 40% of them, though, said they had started seeing more. And nearly as many said they would discontinue seeing Medicaid patients it the parity provision is not extended.
Six states have acted to extend the parity provision for one year: Alabama, Colorado, Iowa, Maryland, Mississippi and New Mexico.
Legislation has been introduced in Congress that would extend the pay increase: A Senate bill introduced by Sens. Sherrod Brown (D-Ohio) and Patty Murray would extend the pay raise for two years; a House of Representatives bill (PDF) sponsored by Rep. John Lewis (D-Ga.) would extend it for five years.
“There are all types of social dynamics being played out,” said Matt Salo, executive director of the National Association of Medicaid Directors, who predicted up to a dozen states may ultimately decide to fund the pay increase if Congress doesn't act.
Many states are waiting to see if Congress does anything, and Congress may be less likely to do anything if more states act on their own, Salo said.
“If I were a betting man, I'd say it's 50-50 that Congress will act—most likely after Jan. 1,” he said. If the pay increase is extended next year it would most likely be made retroactive to the first of the year, he added.
According to the Ohio medical association, there were 10,023 Ohio physicians who received the increased Medicaid reimbursement for primary care. The organization was able to identify an e-mail address for 7,241 of them and invited these doctors to participate in an online survey (PDF) and 559 responded.
“This current rate increase is only temporary and yet has proved invaluable for introducing more patients to high quality healthcare, so just imagine how impactful extending this rate increase could be for improving the long-term overall care of Ohioans and bettering the health of our communities,” Dr. Mary Wall, OSMA president, said in a news release (PDF). “If we go back to reimbursing primary-care physicians at 59 cents on the Medicare dollar, doctors may lose money each time they see patients and thus be forced again to turn away patients who have Medicaid.”
If the Medicaid primary-care parity provision was made permanent, 60% of the Ohio doctors responding to the survey said they would make some Medicaid-related business decisions. Sixty percent said they would see more Medicaid patients, about a third said they'd add staff, and nearly 13% said they'd increase their hours.