Ridiculous Study of the Week: Medicaid Payment
You are not going to believe this but lower Medicaid fees are linked to scarcer primary care appointments. Crazy, right? It amazes me that they had to do a study to prove this. The recent study alluded to, in JAMA Internal Medicine, found that “when the fees paid to healthcare providers by Medicaid go up, appointments with primary care doctors suddenly become more available to Medicaid beneficiaries – and the opposite happens when fees go down”. You don’t say? So is this saying that doctors are greedy? I don’t think so. I just think doctors feel they should be paid for their time and when the payment get’s so ridiculously then you are forcing them to give care for free. And they start pushing back. It is all just basic human nature. Before you judge us let me ask you this: If you are not a doctor, would you enjoy being forced by the government to do something that loses you money? I didn’t think so.
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Actually, this study makes an important point.
The reason docs don’t take Medicaid is not that they hate poor people or don’t like people of color or can’t stand complicated patients – it’s simply that the fee schedule stinks. Period. End of discussion.
Data that supports our side is always welcome, as we know that our enemies – AAFP, CMS, insurers – have none on theirs.
When in private practice, we never took Medicaid, because we had learned in residency that as often as not, it is an invitation to the lazy, complaining, and non-compliant. And if anyone would like to criticize that statement, I offer a cheery “screw you.” We saw self-pays and some charity work, which was OUR decision, not the goverment’s.
Safety nets DO need to exist at the STATE level, and cannot be burdensome or punitive.
But in this time of tax “reform”, why not make all free care simply tax deductible? I know it presently isn’t – why not?
I agree with not taking adult medicaid; we took medicaid so we could have kids come in. as for charity care, there was a program through the buncombe county medical society that you could submit a bill, and while you would not get paid you would get a tax deduction at the end of the year. that would be very easy to implement on a national level for outpatient docs (I believe hospitals do this already for providing charity/indigent care)…
we took 7% medicaid in my prior practice. we figured it out, and anything above 12% would cause us to go bankrupt. unfortunately, our creditors and utilities were not willing to accept the discount we did from the government…
Ridiculous study? Yes.
On the other hand, the rock-heads in charge need concrete proof it actually makes a difference and causes harm. Otherwise, it all gets written off as “the doctors are whining again! Ignore them!”