AAFP Statement: Bringing Medicaid Payments to Medicare Levels For Primary Care Physicians Will Improve Patient Access to Care

Wednesday, May 09, 2012

Statement attributable to:
Glen Stream, MD, MBI
American Academy of Family Physicians

“Access to primary medical care services could become easier for Medicaid beneficiaries, thanks to a new proposed regulation that equalizes Medicaid and Medicare payments for primary care physicians for 2013 and 2014. The regulation released today implements Sec. 1202 of the Affordable Care Act that provides federal funds to states to bring their Medicaid payments for primary care services provided by primary care physicians up to Medicare levels for two years.

“The American Academy of Family Physicians 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.

“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. 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.

“Genuine success, however, depends on stabilizing Medicare payment. 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. 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.

“Moreover, an abrupt end to Medicaid-Medicare parity will wipe out the progress of ensuring that low-income Americans have access to primary medical care. A sudden return to grossly inadequate compensation for Medicaid patients’ care would threaten to once again close the door on people

who have come to know and depend on their primary care physicians. We call on Congress to extend the Medicaid parity beyond two years to ensure that these patients have continued and uninterrupted medical care in the future.”

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Founded in 1947, the AAFP represents 136,700 physicians and medical students nationwide. It is the largest medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.  To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website, www.familydoctor.org(familydoctor.org).