New year will bring far less pay for doctors treating Medicaid patients

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    To the dismay of many physicians, two years of higher Medicaid reimbursements will end Jan. 1.

    As states expanded Medicaid under the Affordable Care Act, legislators knew the program’s notoriously low reimbursement rates might make it tough for patients to find primary care doctors. So as part of health care law, the federal government footed the bill to raise service fees to match those of Medicare.

    With the fee hikes set to expire in 2015, the Urban Institute‘s Stephen Zuckerman said there is some concern about access.

    “By cutting fees by the extent that they will — certainly in New Jersey and Pennsylvania — it’s not going to encourage physicians to see more Medicaid patients,” he said.

    Medicaid fees, which are set by each state, vary widely. According to Zuckerman’s analysis, primary care doctors in Pennsylvania and New Jersey will face cuts of more than 50 percent as they return to their regular rates.

    Fifteen states, including Delaware, have decided to continue the pay raises using their own funds, but 85 percent of Medicaid patients live in states that will not. The First State had already been paying 98 percent of the Medicare rate in its Medicaid program, so the difference is largely negligible.

    “It is conceivable that when physicians realize how much fees are being cut come the beginning of 2015, that there could be a reconsideration of the federal policy,” Zuckerman said.

    As of June of 2014, the payment bump has cost the U.S. an estimated $5.6 billion.

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