AAFP Statement: AAFP Welcomes Medicaid Payment Parity with Medicare, Expresses Concern About the Short-Lived Payment Equity

Thursday, November 01, 2012

Statement attributable to:
Jeffrey Cain, MD
American Academy of Family Physicians

“The American Academy of Family Physicians welcomes efforts to ensure that low-income working families have access to needed care, and today’s final rule bringing Medicaid payments up to par with Medicare for primary care and some preventive health services is a step in the right direction.

“The rule implements Section 1202, ‘Payments to Primary Care Physicians,’ of the Affordable Care Act and increases Medicaid payments for specified primary care services to Medicare levels for 2013 and 2014. The final rule requires state governments to take further action prior to 2013 to implement this provision. So that low-income, working families and the elderly in nursing homes can immediately benefit from this important provision, the AAFP calls on states to act quickly.

“Family physicians work to ensure that Medicaid beneficiaries have access to care. More than six in 10 (64 percent) family physicians accept new Medicaid patients, and these beneficiaries comprise 15 percent of the average family physician’s patient panel. Family physicians commit themselves to a long-term relationship with all their patients — including Medicaid beneficiaries — and provide not only first-contact and preventive services, but also the long-term care for chronic conditions that minimizes hospital admissions and reduces costs to the system. However, increasingly inadequate Medicaid payment has forced nearly two in 10 family physicians to stop accepting new Medicaid patients.

“We know from research that when Medicaid beneficiaries cannot find a physician who accepts new Medicaid patients, they face the same access problems as those who have no insurance. They are less likely to have a usual source of care, to forgo needed preventive and acute care for minor problems, to develop complications that require intensive and costly medical intervention, and to have poorer health status. Though current law limits this parity to only two years, bringing Medicaid payment up to Medicare levels will do much to enable physicians to care for Medicaid patients.

“Moreover, states will receive an estimated $11 billion in new funds over 2013 and 2014 to bolster their Medicaid primary care delivery systems. But this funding is temporary. Unless Congress acts to permanently extend and fund this provision, a sudden return to disparate and inadequate payment for primary care services needed by Medicaid patients after only two years will again threaten to restrict their access to such needed services. It would once again shut out people who have come to know and depend on their primary care physicians. Only by extending Medicaid parity with Medicare can we ensure that these Americans continue to have uninterrupted medical care in the future.”

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Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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