Under a new regulation proposed May 9, federal funds would bring state Medicaid payments up to Medicare levels for primary care services beginning in 2013. As a result, access to primary medical care services could become easier for Medicaid beneficiaries, according to Glen Stream, MD, president of the American Academy of Family Practitioners (AAFP).
“The [AAFP] was pleased that the Affordable Care Act recognized the growing crisis in Medicaid beneficiaries’ access to needed care. We’re equally pleased that this proposed regulation provides a long-needed, positive adjustment in Medicaid payments," said Stream.
“Low-income, working families have known for years that Medicaid failed to ensure access to a doctor when they needed medical care. As states struggled to balance their budgets, Medicaid payment for primary care services plummeted to as low as 36 percent of Medicare compensation," Stream continued. "Such drastically low payments forced physicians to limit the number of Medicaid patients they could accept without putting their practices at serious financial risk. Using federal funds to bring Medicaid payment up to par with Medicare will temporarily ease the financial risk and, in turn, enable physicians to accept additional Medicaid patients. "
Long-term success, however, depends on stabilizing Medicare payment, according to AAFP. "Without a permanent solution to the flawed sustainable growth rate [SGR] formula on which Medicare payment is based, physicians still face a 32 percent Medicare pay cut in 2013 plus an additional 2 percent reduction mandated by last year’s deficit reduction agreement," Stream said. "Medicaid parity with a plummeting Medicare payment would fail to increase low-income Americans’ access to health care, and the AAFP continues to call on Congress to address the SGR."