by Allie Broas, Program and Administrative Assistant

Colorado has announced its placement, among six other states, that plan on extending the Medicaid pay raise for primary care doctors in 2015.

The good news for the doctors treating Medicaid patients extends to Alabama, Iowa, Maryland, Mississippi, New Mexico, and the District of Columbia, as they join Colorado in plans to use their own money to prolong the pay raises through the next year. Alaska and North Dakota will continue with the higher pay rates that they have provided to primary care doctors even before the federally mandated two-year bump took effect in 2013. The remaining 42 states will revert back to the 2012 Medicaid pay rates at the end of the year.

Why is this so important for Colorado? Even before Colorado implemented the Medicaid expansion in early 2014, there were not enough doctors taking Medicaid patients. In 2013, a reported 19.8 percent of Medicaid patients were told by a doctor’s office that they would not accept patients with their insurance, compared to 5.5 percent of patients with private insurance. Cue two-year pay raise for primary care doctors taking Medicaid patients. 

Now, with the expansion of Medicaid under the Affordable Care Act earlier this year, hospitals in Colorado saw an increase of 30.5 percent in Medicaid patients seen in the first quarter alone. This new group of Medicaid patients is largely composed of the previously uninsured, illustrating the vast increase in now-insured Coloradans.

The 42 states reverting to 2012 rates may be missing out on an opportunity to better connect Medicaid patients to primary care. Raising Medicaid’s reimbursement rates to match Medicare’s reimbursement rates was an average 73 percent pay increase ( nationally for those doctors.

It is clear that the law also hit a nerve in two states that originally denied the Medicaid expansion. Both Alabama and Mississippi have approved funding, $32 million and $12 million respectively, from their own budgets to pay for the extended pay raises for primary care doctors.

According to the Department of Health and Human Services, one in five Americans currently receive health insurance through a state Medicaid plan. Despite the lack of clear-cut data on the effects of this pay raise, it is obvious that incentives to get primary care doctors to treat Medicaid patients are a mounting necessity. Colorado hospitals that saw Medicaid patients paid 20.1 percent of all charges in 2014 – a growth from 15.4 percent in 2013 and a representation of the reduction in uncompensated care.  The promise of reduced health care costs for hospitals suggests that, with more doctors in Colorado accepting Medicaid patients under this pay raise, individual providers may be able to provide care to more Medicaid patients or may be able to diminish the cost shift to private insurance.

Still, such incentives to build an adequate Medicaid workforce capacity may fall short in keeping pace to provide Coloradans the care they need when they need it.

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