Doctors Accepting More Medicaid Patients – for Now

“Michigan Primary Care Docs Have Room for New Patients,” reports Michigan Radio. The story cites a Center for Healthcare Research and Transformation study, which finds a 19 percent increase in the number of Michigan doctors accepting Medicaid patients, leaving the impression that Medicaid expansion in Michigan is a success.

ForTheRecord says: The vast majority of Medicaid benefits in Michigan are delivered through HMO-like “managed care” contracts, rather than the traditional “fee for service” system in which patients must find a health care provider on their own who is willing to accept Medicaid’s below-market payment. Under managed care, the state negotiates a flat per-beneficiary fee with local hospitals. For that price, a hospital (and its network of subsidiary providers) must then provide all the health care services each beneficiary needs, including “primary care.” Given this, it’s uncertain how meaningful the “19 percent increase” for independent primary care doctors really is.

Also, “for a limited time only” (2013 and 2014) the federal government increased Medicaid primary care reimbursements rates, part of the campaign to entice states adopt the Obamacare Medicaid expansion. But that extra federal money stopped flowing on Dec. 31. The Michigan Legislature appropriated $25 million to boost payments to providers, but again, it’s not clear how much this helps patients in an overwhelmingly managed-care system.