Featured Research

from universities, journals, and other organizations

Doctors likely to accept new Medicaid patients as coverage expands

Date:
October 16, 2013
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
The upcoming expansion of Medicaid under the Affordable Care Act (ACA) won't lead physicians to reduce the number of new Medicaid patients they accept, suggests a study.

The upcoming expansion of Medicaid under the Affordable Care Act (ACA) won't lead physicians to reduce the number of new Medicaid patients they accept, suggests a study in the November issue of Medical Care, published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

However, doctors may be less likely to accept those patients who remain uninsured, according to an analysis of historical data by Lindsay M. Sabik, PhD, and Sabina Ohri Gandhi, PhD, of Virginia Commonwealth University, Richmond. They write, "Our results suggest that after increases in Medicaid coverage within a market, access may be limited for the remaining patients."

Doctors Likely to Continue Accepting Medicaid Patients After Expansion

As part of the ACA, Medicaid coverage will expand substantially beginning in 2014, with the goal of improving the health of people who were previously uninsured. Whether that goal is achieved will partly depend on how doctors respond to changes in their local market -- and how those decisions affect low-income individuals who rely on "safety-net" care.

Drs Sabik and Gandhi analyzed data from a long-term, nationwide study of changes in the health care system (the Community Tracking Study Physician Survey). Physician survey responses from the mid-1990s to the mid-2000s were analyzed to assess how market-level changes in Medicaid coverage affected doctors' acceptance of new patients: both patients covered by Medicaid and uninsured patients who were unable to pay.

For most of the period studied, Medicaid coverage rates increased while uninsurance rates trended lower. Both rates varied between different markets. About 70 percent of physicians surveyed were in solo or group medical practice.

The data suggested that changes in Medicaid coverage did not significantly affect doctors' acceptance of new Medicaid patients. "[P]hysicians who were already accepting (or not accepting) Medicaid patients before changes in Medicaid coverage rates continue to do so," Drs Sabik and Gandhi write.

On average, new Medicaid patients were accepted by about 72 percent of office-based and 90 percent of facility-based doctors (those who work at hospitals or other facilities). These rates remained about the same after changes in Medicaid coverage.

But May Not Accept Patients Who Remain Uninsured

However, when Medicaid coverage rates increased, physicians became less likely to accept new uninsured patients. For each one percentage point increase in Medicaid coverage, there was a one-half point decrease in the likelihood that doctors would accept new uninsured patients.

Office-based physicians were more likely to stop accepting new uninsured patients in response to changes in Medicaid coverage. Charity care was unaffected by changes in Medicaid coverage, but increased in markets where more people became uninsured.

While Medicaid expansion will reduce the number of people who are uninsured, "coverage does not guarantee access," the researchers write. Practice decisions made by doctors in response to financial incentives will affect access to care for newly insured patients. Estimates suggest that "a substantial number" of people will remain uninsured despite Medicaid expansion, and some states do not plan to expand Medicaid coverage.

"Our results indicate that past changes in market-level Medicaid coverage have not been associated with changes in overall physician acceptance of new Medicaid patients or the share of a physician's practice revenue from Medicaid," Drs Sabik and Ghandi write. However, changes in Medicaid coverage "have led to lower acceptance of uninsured patients, particularly among office-based physicians."

Based on their findings, Drs Sabik and Ghandi suggest that additional support or incentives may be needed to ensure access to care for people who are still uninsured after Medicaid expansion. "Future research should assess how changes in physician workforce and incentives to physicians under the ACA affect care for those newly insured by Medicaid and the remaining uninsured," the researchers conclude.


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Lindsay M. Sabik, Sabina Ohri Gandhi. Impact of Changes in Medicaid Coverage on Physician Provision of Safety Net Care. Medical Care, 2013; 51 (11): 978 DOI: 10.1097/MLR.0b013e3182a50305

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "Doctors likely to accept new Medicaid patients as coverage expands." ScienceDaily. ScienceDaily, 16 October 2013. <www.sciencedaily.com/releases/2013/10/131016112519.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2013, October 16). Doctors likely to accept new Medicaid patients as coverage expands. ScienceDaily. Retrieved April 24, 2014 from www.sciencedaily.com/releases/2013/10/131016112519.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "Doctors likely to accept new Medicaid patients as coverage expands." ScienceDaily. www.sciencedaily.com/releases/2013/10/131016112519.htm (accessed April 24, 2014).

Share This



More Health & Medicine News

Thursday, April 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Big Pharma Braces for M&A Wave

Big Pharma Braces for M&A Wave

Reuters - Business Video Online (Apr. 22, 2014) Big pharma on the move as Novartis boss, Joe Jimenez, tells Reuters about plans to transform his company via an asset exchange with GSK, and Astra Zeneca shares surge on speculation that Pfizer is looking for a takeover. Joanna Partridge reports. Video provided by Reuters
Powered by NewsLook.com
Study Says Most Crime Not Linked To Mental Illness

Study Says Most Crime Not Linked To Mental Illness

Newsy (Apr. 22, 2014) A new study finds most crimes committed by people with mental illness are not caused by symptoms of their illness or disorder. Video provided by Newsy
Powered by NewsLook.com
Hagel Gets Preview of New High-Tech Projects

Hagel Gets Preview of New High-Tech Projects

AP (Apr. 22, 2014) Defense Secretary Chuck Hagel is given hands-on demonstrations Tuesday of some of the newest research from DARPA _ the military's Defense Advanced Research Projects Agency program. (April 22) Video provided by AP
Powered by NewsLook.com
How Smaller Plates And Cutlery Could Make You Feel Fuller

How Smaller Plates And Cutlery Could Make You Feel Fuller

Newsy (Apr. 22, 2014) NBC's "Today" conducted an experiment to see if changing the size of plates and utensils affects the amount individuals eat. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins