Dive Brief:
- Large numbers of physicians who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report.
- Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of HHS. Also: More than one-third of providers could not be found at the location listed by a Medicaid managed-care plan.
- About 8% of providers were at the locations listed, but said they did not participate in the Medicaid health plan with which they were supposedly affiliated. Another 8% participated in Medicaid, but were not accepting new patients.
Dive Insight:
While the Affordable Care Act expands Medicaid coverage, many analysts predicted that many new Medicaid patients in some parts of the country would have a hard time finding primary care. Physicians drop out of Medicaid every year, and a growing number of those are claiming they can't stay profitable and participate in the program. This suggests the ACA's Medicaid expansion needs an adjustment so healthcare providers have incentives to keep serving beneficiaries.
As HHS inspector general Daniel R. Levinson noted, the less-than-hoped-for number of providers offering services to Medicaid enrollees raises questions about the adequacy of provider networks.
And even if a patient is lucky enough to find a provider to take him or her, it may not be under ideal circumstances: Among the providers who offered appointments, the median wait time was two weeks, according to the report.
