An article in last month’s New England Journal of Medicine has found that the increased reimbursements to doctors through Medicaid as a result of the ACA had an impact on increasing access to health care services. Under the Affordable Care Act some providers accepting Medicaid were to receive reimbursement rates that match those of Medicare. The provision covered the years 2013 and 2014. Historically, one of the major challenges for poor populations is to find doctors who will accept the Medicaid reimbursement rates. The rates, set by each of the states, tend to be much lower than Medicare and private plans and in many poor urban and rural areas doctors may be difficult to find.
The research, Appointment Availability after Increases in Medicaid Payments for Primary Care found, “The availability of primary care appointments in the Medicaid group increased by 7.7 percentage points, from 58.7% to 66.4%, between the two time periods. The states with the largest increases in availability tended to be those with the largest increases in reimbursements, with an estimated increase of 1.25 percentage points in availability per 10% increase in Medicaid reimbursements. No such association was observed in the private-insurance group. During the same periods, waiting times to a scheduled newpatient appointment remained stable over time in the two study groups.”
The findings may seem obvious to many but low Medicaid rates can be a major budget savings for states over the years despite the negative health outcomes. The study concludes by saying that “Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times.”