54% of Calif. Doctors Accepted New Medicaid Patients in 2013

About 54% of physicians in California said they were accepting new Medicaid patients in 2013 — the second-lowest rate among all U.S. states, according to a new CDC report, the Newark Star-Ledger reports (Livio, Newark Star-Ledger, 3/31).

For the report — conducted between February 2013 and June 2013 — researchers analyzed data from the 2013 National Electronic Health Records Survey (CDC report, March 2015).

Report Findings

Overall, the report found about 69% of physicians across the U.S. said they were accepting new Medicaid patients in 2013 (Newark Star-Ledger, 3/31).

According to the report, New Jersey had the lowest percentage of physicians accepting new Medicaid patients in 2013, at 38.7%. California had the second-lowest percentage, at 54.2%, followed by Florida, Louisiana and New York (Evans, CQ News, 4/2). Nebraska had the highest percentage of doctors accepting new Medicaid patients, at 96.5%.

Meanwhile, researchers found that 83.7% of physicians in 2013 were accepting new Medicare patients, while 84.7% were accepting new patients with private insurance (CDC report, March 2015).

Effects of ACA Reimbursement Bump Unknown

The report did not account for Medicaid reimbursement increases under the Affordable Care Act (CQ News, 4/2). Under the Affordable Care Act, the “Medicaid fee bump” program allotted more than $5 billion in federal funding to bring primary care reimbursement rates in line with those under Medicare (California Healthline, 1/2). However, some states experienced implementation delays and did not enact the payment bumps until later in 2013, according to the report (CQ News, 4/2).

California has one of the lowest Medicaid reimbursement rates in the U.S. Specifically, data from the California Medical Association show that:

• Medicare in April 2014 paid $45.69 for a traditional office visit for a returning patient; and
• Medicaid in April 2014 paid a standard rate of $18.10 for a traditional office visit for a returning patient.

The two-year Medicaid federal rate increase expired with the start of 2015 (California Healthline, 1/2).

CDC researchers said that the agency will have to examine 2014 data “to determine if physician acceptance of new Medicaid patients increased” as a result of the higher reimbursement rates (Newark Star-Ledger, 3/31).

Original article posted by Bob Herman of Modern Healthcare on March 28, 2015