Physicians to face steep Medicaid cuts starting Jan. 1

Without an act of Congress, the increased Medicaid fees for primary care physicians caring for low-income patients as part of the Patient Protection and Affordable Care Act will expire on December 31, 2014.

Should the federally funded fee bump expire, Medicaid primary care fees would be reduced by roughly 42.8 percent across the country, according to a recent Urban Institute study.

The fees could be reduced by more than 50 percent in the following seven states:

  • Rhode Island (67.3 percent expected decrease in fees)
  • California (58.8 percent)
  • Michigan (58 percent)
  • New York (55.3 percent)
  • New Jersey (52.9 percent)
  • Florida (52.5 percent)
  • Pennsylvania (52.4 percent)

Four states — Alaska, Maryland, Montana and North Dakota — would likely experience no reduction in Medicaid primary care fees for eligible physicians.

Although the impact of the bump expiring would vary from state to state, fee reductions would be more severe in states that have indicated they do not plan to extend the fee increase, with an estimated reduction of 47.4 percent. States that plan to extend the fee increase would be more likely to see reductions of around 31 percent, according to the report.

Although physicians probably won't drop their current Medicaid patients, the significant decrease in primary care reimbursement may lead physicians to avoid taking on new Medicaid patients, potentially leading to access problems for Medicare patients, according to the study.



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