About 65,000 providers have recently lost eligibility for Medicaid reimbursement, many for failure to comply with an ACA provision requiring certain providers to submit revalidation notices last year, an analysis conducted by Modern Healthcare shows.
The report raises concern over access to care for Medicaid beneficiaries, particularly in states like Texas, which lost more than 10,000, or almost 10%, of its 298,000 Medicaid providers.
- While some providers lost eligibility due to the ACA rule, it seems some states are still evaluating revalidation notices and that some providers left the program voluntarily.
The Modern Healthcare analysis drew from 15 state agencies to reach its conclusions. Medicaid is often criticized for the low rates it pays providers and there is constant debate over the access to services that it affords, although some data suggest Medicaid offers similar access to private insurance.
According to the the 2014 Commonwealth Fund Biennial Health Insurance Survey, Medicaid beneficiaries were just as likely as patients with private insurance to have a regular source of care. In a review of research on Medicaid expansion, the Kaiser Family Foundation determined that evidence suggests expansion improved across multiple measures. While some research suggests provider shortages in some areas, providers have been able to accommodate increased patient volume in most instances.
Medicaid rates can discourage provider participation, paying as low as 60% of Medicare rates for certain services. Only 68.9% of office-based physicians were accepting new Medicaid patients, according to 2013 data from the National Center for Health Statistics. Meanwhile, 83.7% were accepting new Medicaid patients and 84,7% were accepting new patients with private insurance.