Overall, when the mean Medicaid fee for a patient office visit went from $68.58 in 2012 to $107.38 in 2014 and then $75.67 in 2016, appointment availability tracked a similar pattern. In 2012, 56.2% of patients got an appointment while in 2012 it was 65.5% and then 61.5% in 2016. New Jersey, Georgia and Texas experienced the largest decreases in appointment availability, with 9.1, 10.9 and 10.1 percentage-point drops, respectively.
In comparison, a total of 11,071 calls made by simulated patients with private insurance over the same periods showed no changes in appointment availability.
“The relationship is very strong between the proportion of providers who participate in a network and those that see patients with that particular insurance type,” Polsky told Reuters Health by phone.
One limitation of the study is that it only measured the impact of Medicaid funding in 10 states, the authors note.
“This study was very focused on what doctors offices were saying, but it doesn’t tell you what each patient was experiencing,” said Dr. Benjamin Sommers, an associate professor of health policy and economics at the Harvard T. H. Chan School of Public Health in Boston, who wasn’t involved in the research.
“If they didn’t get an appointment you have to wonder whether they will ultimately get the care they need. Is this just a slight inconvenience where they will have to make an extra call, or does this mean they were not being seen at all. There are different implications,” Sommers said in a phone interview.
One of the reasons the study results are important is their relation to the debate this year over whether to “block grant” Medicaid, Polsky said. That would mean less funding for the program, potentially leading providers to leave the Medicaid market.
Reference
- Candon M, Zuckerman S, Wissoker D, et al. Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients. JAMA Internal Medicine. 2017 Nov 13. [Epub ahead of print]
