A Baseline To Measure Future Acceptance Rates −

As part of the Affordable Care Act, primary care physicians providing services to patients insured through Medicaid in some states will receive higher payments in 2013 and 2014 than in the past. Payments for some services will increase to match Medicare rates. This change may lead to wider acceptance of new Medicaid patients among primary care providers. Using data from the 2011–12 National Ambulatory Medical Care Survey Electronic Medical Records Supplement, I summarize baseline rates of acceptance of new Medicaid patients among office-based physicians by specialty and practice type. I also report state-level acceptance rates for both primary care and other physicians. About 33 percent of primary care physicians (those in general and family medicine, internal medicine, or pediatrics) did not accept new Medicaid patients in 2011–12, ranging from a low of 8.9 percent in Minnesota to a high of 54.0 percent in New Jersey. Primary care physicians in New Jersey, California, Alabama, and Missouri were less likely than the national average to accept new Medicaid patients in 2011–12. The data presented here provide a baseline for comparison of new Medicaid acceptance rates in 2013–14. T he Supreme Court’s 2012 ruling on the Affordable Care Act gave states the option to expand Medicaid coverage to adults with income no more than 133 percent of the federal poverty level. States participating in the law’s Medicaid expansion will receive 100 percent federal financing for new enrollees from 2014 through 2016—an option expected to add millions of people to the program. A mandatory income disregard equal to 5 percent of poverty makes the effective income limit 138 percent of poverty. In addition to somepeople experiencing shortterm uninsurance because of the recent economic downturn, a substantial number of new Medicaid enrollees are likely to be long-term uninsured adults who have had little contact with the health care system beyond episodic care for urgent or emergent conditions. Some experts are concerned that the existing health care workforcemight not be sufficient to provide care to these newly insured people. However, other provisions of the Affordable Care Act seek to strengthen the primary care workforce. Additionally, Medicaid payment rates for some primary care services provided by primary care physicians are increasing to 100percent ofMedicare rates in 2013 and2014. The payment change will greatly affect Medicaid payment rates in stateswhere rates arewell belowMedicare rates. Although many factors potentially unrelated to Medicaid policy levers affect the number of Medicaid patients seen by physicianswho accept at least some Medicaid patients, the level of Medicaid physician payment has been shown doi: 10.1377/hlthaff.2013.0361