Medicaid Growth and Primary Care Physician Supply: a Grim Outlook

A newly released study by the Center for Studying Health System Change (HSC) sheds light on two growing problems - a huge anticipated Medicaid enrollment growth, and the supply (or rather, lack thereof) of primary care physicians available to treat them. 

As recently as 2008, just 42 percent of U.S.-based primary-care physicians accepted new patients covered by the program (due to the program’s low reimbursement rates, among other things), while 84 percent accepted most all patients with private insurance, according to the study, based on responses of 1,748 physicians who identified their specialties as general internal medicine, family practice, or general pediatrics, the specialties eligible for increased Medicaid reimbursement.

What makes the situation worse: Temporary increases in Medicaid reimbursement meant to entice more primary care physicians into accepting Medicaid patients are unlikely to make much of a difference in the states facing the biggest enrollment jumps, according to researchers.

The study also found that states with the smallest number of primary care physicians per capita overall - generally in the South and Mountain West - potentially will see the largest percentage increases in Medicaid enrollment (the opposite is true for the PCP-populated Northeast, which will see only modest increases in Medicaid enrollment).

“The study’s bottom line is that growth in Medicaid enrollment in much of the country will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients resulting from increased reimbursement,” says HSC senior fellow Peter J. Cunningham, Ph.D., the study’s author, in a press release.

Though it’s unclear what this will mean for physician practices in the future (besides, of course, higher demand for pediatricians and general/family practitioners), a number of news media outlets are weighing in on the grim-leaning outlook.

According to a report published by the Pittsburgh Post-Gazette, the "takeaway" from the study is that the Medicaid expansion has the potential to exacerbate America's physician shortage. Other studies suggest that after the Affordable Care Act takes effect, the country will need between 30,000 and 40,000 physicians in order to adequately care for the new, higher patient load, the report noted.

A Wall Street Journal Health Blog entry posted just yesterday notes that physician groups and policy-makers have been warning for years - well before the Affordable Care Act was even a gleam in President Obama’s eye - that we are facing a shortage of physicians in general, and particularly of primary-care doctors.

The health-care overhaul is expected to exacerbate the doctor shortage by increasing the number of people, previously uninsured, who can now obtain care, according to the blog.

We’d like to hear from you. What do you think of the shortage of primary care physicians who accept Medicaid patients will mean for this patient population’s growing numbers? Post your response below.