Physicians may need more than higher reimbursements to expand medicaid participation: Findings from Washington state

Health Affairs

Volumn 32, Issue 9, 2013, Pages 1560-1567

  Long, Sharon K ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ADULT; ARTICLE; CLINICAL PRACTICE; ELECTRONIC MEDICAL RECORD; FEMALE; GENERAL PRACTITIONER; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAID; MEDICAL FEE; MEDICAL SPECIALIST; PATIENT CARE; PATIENT REFERRAL; PHYSICIAN; PHYSICIAN ATTITUDE; PRIVATE PRACTICE; REIMBURSEMENT; RURAL HEALTH CARE;

HEALTH REFORM; MEDICAID; PHYSICIAN PAYMENT; PRIMARY CARE; STATE AND LOCAL ISSUES;

ATTITUDE OF HEALTH PERSONNEL; FOCUS GROUPS; HEALTH CARE COSTS; HUMANS; INSURANCE, HEALTH, REIMBURSEMENT; MEDICAID; PATIENT PROTECTION AND AFFORDABLE CARE ACT; PHYSICIANS, PRIMARY CARE; QUESTIONNAIRES; REFUSAL TO TREAT; UNITED STATES; WASHINGTON;

EID: 84885369216     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.1010     Document Type: Article

References (22)

1. With the June 28, 2012, Supreme Court ruling, states cannot be penalized for failing to comply with the act's Medicaid expansion, making that policy a state option. See National Federation of Independent Business v. Sebelius, 567 U.S., 2012 WL 2427810 (2012 Jun 28).
2. Congressional Budget Office. Estimates for the insurance coverage provisions of the Affordable Care Act updated for the recent Supreme Court decision [Internet]. Washington (DC): CBO; 2012 Jul [cited 2013 Jul 23]. Available from: http://www.cbo.gov/sites/default/ files/cbofiles/attachments/43472- 07-24-2012-CoverageEstimates.pdf
3. Kenney GM, Dubay L, Zuckerman S, Huntress M. Making the Medicaid expansion an ACA option: how many low-income Americans could remain uninsured. Washington (DC): Urban Institute; 2012 Jun.
4. Ku L, Jones K, Shin P, Bruen B, Hayes K. The states' next challenge- securing primary care for expanded Medicaid populations. N Engl J Med. 2011;364(6):493-5.
5. Goodson JD. Patient Protection and Affordable Care Act: promise and peril for primary care. Ann Intern Med. 2010;152(11):742-4.
6. Long SK, Stockley K, Grimm E, Coyer C. National findings on access to health care and service use for non-elderly adults enrolled in Medicaid. Washington (DC): Urban Institute; 2012. (MACPAC Contractor Report No. 2).
7. Government Accountability Office. Medicaid and CHIP: most physicians serve covered children but have difficulty referring them for specialty care. Washington (DC): GAO; 2011 Jun 30. (Report No. GAO-11-624).
8. Cunningham PJ, Nichols LM. The effects of Medicaid reimbursement on the access to care of Medicaid enrollees: a community perspective. Med Care Res Rev. 2005;62(6): 676-96.
9. Shen YC, Zuckerman S. The effects of Medicaid payment generosity on access and use among beneficiaries. Health Serv Res. 2005;40(3): 723-44.
10. Decker SL. Changes in Medicaid physician fees and patterns of ambulatory care. Inquiry. 2009;46(3): 291-304.
11. Decker SL. In 2011 nearly one-third of physicians said they would not accept new Medicaid patients, but rising fees may help. Health Aff (Millwood). 2012;31(8):1673-8.
12. Kaiser Family Foundation. Summary of the Affordable Care Act [Internet]. Menlo Park (CA): KFF; [last modified 2013 Apr 23; cited 2013 Jul 31]. Available from: http://kaiserfamily foundation.files.wordpress.com/ 2011/04/8061-021.pdf
13. Other provisions likely to affect access to primary care for Medicaid enrollees include new funds for workforce training (including for midlevel primary care practitioners) and loan forgiveness programs.
14. Boukus ER, Casil A, O'Malley AS. A snapshot of US physicians: key findings from the 2008 health tracking physician survey. Washington (DC): Center for Studying Health System Change; 2009. (Data Bulletin No. 35).
15. Cunningham PJ, May JH. Medicaid patients increasingly concentrated among physicians. Washington (DC): Center for Studying Health System Change; 2006. (Tracking Report No. 16).
16. Cunningham PJ. State variation in primary care physician supply: implications for health reform Medicaid expansions. Washington (DC): Center for Studying Health System Change; 2011. (Research Brief No. 19).
17. The findings were similar if the definition of primary care was expanded to include physicians with a specialty of general OB/GYN or physicians practicing in hospital outpatient settings.
18. Decker SL. Two-thirds of primary care physicians accepted new Medicaid patients in 2011-12: a baseline to measure future acceptance. Health Aff (Millwood). 2013;32(7):1183-7.
19. Based on author's calculations using the data from the Current Population Survey for 2011; and State Health Access Data Assistance Center. Data center [Internet]. Minneapolis (MN): SHADAC; [cited 2013 Jul 24]. Available from: http://www.shadac .org/datacenter
20. Based on 2012 state population estimates from the item in the next note and on data for 2012 from Kaiser Family Foundation. State health facts: primary care physicians by field [Internet]. Menlo Park (CA): KFF; [cited 2013 Jul 24]. Available from: http://kff.org/other/stateindicator/ primary-care-physiciansby- field/
21. Census Bureau. Population estimates: state totals: vintage 2012 [Internet].Washington (DC): Census Bureau; [cited 2013 Jul 24]. Available from: http://www.census .gov/popest/data/state/totals/ 2012/index.html
22. Based on unpublished tabulations from the Urban Institute's 2010 Medicaid Physician Fee Survey.