Medicaid patients are losing their doctors as the federal government lowers reimbursement rates for health care providers.
Doctors have a choice in which health insurance they accept, and not all of them opt into the government-run Medicaid and Medicare, which serve low-income and senior Americans.
Over the years, fewer doctors have accepted Medicare and Medicaid as the payments have lowered by a whopping 26 percent since 2001, according to the American Medical Association.
For next year, the Centers for Medicare and Medicaid Services (CMS) plans to implement even more cuts—specifically a 2.8 percent conversion factor reduction to the fee schedule.
As the payments become lower and lower, many doctors have decided to drop their Medicare and Medicaid patients altogether, and it's been a long time coming.
In a 2023 survey from Medscape, only 65 percent of surveyed doctors said they would continue to take new Medicare and Medicaid patients, and 8 percent said they would no longer accept them.
Now this year, in a newer survey, 14 percent of doctors said they would be trying to limit their Medicaid patient counts, and 66 percent said the biggest problem they faced with Medicaid was the reimbursement rates.
"This has been an unfortunate trend for a few years now and is only getting worse," Alex Beene, a financial literacy instructor at the University of Tennessee at Martin, told Newsweek.
"The reality for most doctors is that more and more of their operation's revenue depends on getting reimbursed from insurance, Medicaid, and Medicare, and the more difficult it is to get reimbursed, the more likely it is to see doctors drop acceptance. The sad part is this is hurting both doctors, their staff, and their patients."
Many doctors find after dropping patients, they have a lower patient volume but higher overall revenue.
"It is more and more common for doctors to stop accepting Medicare and Medicaid," Chris Fong, a Medicare specialist and the CEO of Smile Insurance, told Newsweek. "The ones I have spoken to feel that the additional paperwork and red tape prevents them from being doctors and caring for their patients."
However, for patients, the loss of potential physicians can be hard felt.
"This is extremely disruptive to patient care," Fong said. "We see time and time again where someone is in the middle of treatments and their doctor stops accepting Medicare which forces the patient to find a new doctor and reestablishing treatments. Unfortunately, people on Medicare or Medicaid don't usually have an alternative option than to change their doctor or cash pay."
With fewer doctors accepting their insurance, they may be forced to find lower-quality care or travel long distances to see a provider who does take Medicare or Medicaid. That ultimately could lead to delayed care and missed diagnoses.
But there are stark ramifications for health care workers as well.
"With few reimbursements coming in, that means patients are not getting the service they need and large numbers of employees in the medical field are seeing their salaries stall," Beene said. "If you're a patient who finds yourself in this situation, you may have no other option than to shop around. It could mean the difference in hundreds or thousands of extra dollars depending on what's covered and what's not."
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