Ranking well below the national average of 69%, a U.S. Centers for Disease Control and Prevention report show that only 38.7% of New Jersey doctors are accepting new Medicaid patients in 2013, making New Jersey the lowest ranking state (the 2011/2012 survey placed New Jersey at 46%, still at the bottom). California comes in second at 54.2% while New Jersey neighboring states of New York, Pennsylvania and Delaware come in at 57%, 81% and 80%, respectively. Physician in the state of Nebraska were the most likely to accommodate newly enrolled patients coming in at 96.5%
While in the past New Jersey has had very low Medicaid physician reimbursement rates, Obamacare raised the rates in 2013 and 2014 to match Medicare rates, effectively giving New Jersey doctors a 109% increase in pay (according to Kaiser Health News) with the national average coming in at a 73% increase. The federal government accomplished this by covering the difference between Medicare and Medicaid reimbursement rates for 146 primary-care services and pediatric sub-specialties from Jan. 1 through the end of 2014. 2014 data on the Medicaid patient acceptance rate will be more telling as the pay increases will not have been delayed due to federal budget cuts like they had in 2013.
New Jersey is one of 27 states and the District of Columbia that accepted billions of dollars in federal aid to expand Medicaid eligibility to include adults without children. Governor Chris Christie’s proposed state budget dedicates $45 million to bump-up physician reimbursements. Still, New Jersey Medicaid patients had a difficult time finding a doctor to treat them. Deborah Briggs, president and CEO for the New Jersey Council of Teaching Hospitals fears that people who can’t find a doctor to take their Medicaid insurance will just go to the emergency room as they always have and that could derail one of the big goals of the health care law which is to curb expensive emergency room use.
Reasons for reluctance to accept the Medicaid patients, even with the reimbursement being equal, ranged from doctors unwilling to take on new patients only to have to see them leave when the rate equalization ended; or doctors feeling they were unable to care for patients that so often had very many medical issues that needed to be addressed; to medical practices seeing high cancellation and no show rates due to many Medicaid patients not having access to reliable transportation.
In 2015 budget negotiations, President Obama proposed a one-year extension of the Medicaid payment equalization, but that provision was not part of the final budget agreement. Congress repeatedly postponed the cuts by passing legislation that temporarily kept reimbursement rates roughly unchanged. With no extension, doctors treating Medicare patients will see an average 21.2 percent reimbursement cut.
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