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More Doctors Need to Accept Medicaid Patients

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    If there is one thing that frustrates me about our current healthcare system, it is that far too few physicians accept Medicaid patients. While the Affordable Care Act has given millions of individuals and families access to healthcare for possibly the first time in their lives, there aren't nearly enough health care professionals who are willing to accept Medicaid patients. This needs to change.

    I want to make sure individuals who have Medicaid understand that this frustration of mine has nothing to do with individuals who have Medicaid having access to hospital care. If you have an emergency and need to go to a hospital then a doctor will have to see you and your Medicaid coverage will kick in. My frustration is exclusively with primary care doctors who won't accept Medicaid patients for physicals and other preemptive health care needs.

    What I think we need to do is pass an amendment to the ACA that forces doctors who accepts any form of Federal reimbursement to accept Medicaid patients. If they are willing to take money from one government program then they should have to take money from all government programs.

    What do you think? Is this something that could actually work or am I missing something here?

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    justin412 Wrote: What do you think? Is this something that could actually work or am I missing something here?
    I think that's a great idea. It doesn't make any sense why doctors aren't forced to accept Medicaid patients. I don't think doctors who only do voluntary services like optional* (tummy tucks, breast enhancement, etc.) plastic surgery or other niche fields should be forced to accept Medicaid, but primary care physicians should definitely have to accept Medicaid patients.
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    The reason most doctors don't accept Medicaid, or limit it, is due to the reimbursement rates. I work in a dental office and if we see an adult with a toothache, do a x-ray and extraction the doctor actually ends up paying a large portion of overhead out of pocket. It does not even cover the expense of employees. Some procedures it pay as low as 25% reimbursement for the fee. So you are saying to FORCE doctors to accept this insurance? Most doctors come out of school more than 100,000.00 in debt the day they graduate, pay over 400,000.00 just to open an office. It's not that the doctors don't want to treat these patients, the doctors would be FORCED into bankruptcy if they had a practice with a large volume of Medicaid. Would you or anyone for that matter want the Government forcing to actually pay out of pocket to work? I do the books at this office, I can tell you it happens more often than you would ever think.
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    LizetteH Wrote: The reason most doctors don't accept Medicaid, or limit it, is due to the reimbursement rates. I work in a dental office and if we see an adult with a toothache, do a x-ray and extraction the doctor actually ends up paying a large portion of overhead out of pocket. It does not even cover the expense of employees. Some procedures it pay as low as 25% reimbursement for the fee.

    I'm not saying that there aren't other serious issues we would need to address at the same time, but we are all paying for it in one way or another.

    Let's use the example of a dental office. Someone with Medicaid is not able to obtain services because the dentist doesn't accept Medicaid patients or has reached their self imposed "limit." Then this someone needs a root canal and has to go to the emergency department at their local hospital because no dentist will accept them. This root canal now costs the taxpayer a lot more than it ever would if this patient were able to go to a dentist in the first place.

    LizetteH Wrote:So you are saying to FORCE doctors to accept this insurance? Most doctors come out of school more than 100,000.00 in debt the day they graduate, pay over 400,000.00 just to open an office. It's not that the doctors don't want to treat these patients, the doctors would be FORCED into bankruptcy if they had a practice with a large volume of Medicaid. Would you or anyone for that matter want the Government forcing to actually pay out of pocket to work? I do the books at this office, I can tell you it happens more often than you would ever think.

    In no way did I mean to suggest that we should force doctors to accept Medicaid patients without making sure they are more fairly reimbursed for their services. We can pass a comprehensive amendment to existing law that makes doctors who accept Federal funding to accept a certain number of Medicaid patients, but then mandate that they will receive fair compensation for their services.

    As I said earlier--we are paying for it either way. We might as well pay less on the front end instead of waiting until an individual has to go to the hospital and incur a far higher cost to the taxpayer.

    And don't even get me started about the costs new doctors and other medical professionals take on to finish school, because I am in full agreement with you there. I think that if someone is willing to commit their lives to the medical profession then they should incur as minimal a cost as humanly possible to complete their studies. It shouldn't cost hundreds of thousands of dollars to become a doctor or any other medical professional.

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    This is also something that really frustrates me. If more physicians accepted Medicaid patients then health care costs would go down, not up.

    When a doctor won't accept a Medicaid patient then that individual will wind up going to a hospital Emergency Room for basic care. Emergency Room's are astronomically more expensive than a doctors office and those costs are then passed down to the individuals who do have insurance. That increases the premiums for individuals who do have insurance and continues an endless cycle that we have to get a hold of eventually.

    I think we need new regulations that provide more incentives for primary care physicians to accept more Medicaid patients without making them take on the entire burden of the added cost all by themselves. If we can figure out a way to pay doctors more for accepting Medicaid patients then all of us will pay less in the end. I know it's hard to believe, but it's just simple economics.

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    Local networks and large medical groups block patient's access to solo doctors who are willing to accept Medicaid patients. The consolidation and buy out of doctor practices is fueled by low reimbursements obviously - its catch-20 and patients suffer while doctors are struggling to keep doors open.

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    Primary care MDs get about 50c to see a Medicaid patient. If they see 4 patient in an hour, that's only $2 per hour, way below the minimum wage. Not mention MDs have to pay offices, employees, malpractice insurance, hospital privileges, etc on top of their loans to go to medical schools. How can MDs survive on $2 hourly income? I'd rather flip burgers than seeing Medicaid patients.
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    I live in Lexington NC and was looking for a medicaid provider close to me. I see from the computer that there aren't any available within 200 miles from me. So why have medicaid if I can't use it. It's too confusing to try and find any information on what it covers.
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    The problem with the entire health care system now, is that there is not enough money in the system, and not enough money available in the economy to provide all the servicess, promised, and now demanded by tax payers, and there never will be. The problem is compounded by people like me who simply can not afford the premiums of plans I qualify for, because my income is to small for tax credit help, and live in states without expanded Medicaid benefits. Universal health care was presented to us as a way of controlling health care costs, and making health care available to us all. Of those I've spoken with, I have yet to talk to anyone whose costs have gone down, or their benefits have improoved other than those who are now on medicaid and had no coverage. So not only have the premiums increased for those who buy their own insurance, but they are also paying more into Uncle Sam for medicaid benefits. And those of us who fall in the middle are subject to $5000 fines for not signing up, which in my case is more affordable than the costs of insurance, particularly when you figure in the out pocket expenses before using the coverage. And the plain truth is there is no way to fix it without wrecking the ecconoky long term. I'm not ever going to complain about my station in life, because even though I've been dealt a few bad hands through the years. I paid my own though and now our government has forced me into a position of having to going on the dole, which I apparently would need to find a state where a lower leg amputation qualifies you for medicaid, or work harder so I can at least afford the $5000 penalty. I'm not alone. Even though the others like me that I know are from small town or rural locations, where our costs of living are much less, the rates of market place plans are often more than our gross income. Check the number of uninsured. Most are not without coverage because they want to be. We can discuss fixing this mess for the next five decades, but everyone can not recieve the same level of heathcare and have the overall level rise. There is simply not enough money in the world to provide everyone the finest care available, but with government controlling the system we are all going to receive expensive inferior care. I accept the fact that at some point I may die because I can afford care, and at some point in the future, if we continue down this path, many people will face that prospect, becausse government can not provide us with new expensive care, and insurance companies are not going to bankrupt themselves. I could afford a policy for a catastrophic care policy in the past and small emerceny policy, but those are no longer available, so now all I have is life insurance to help pay after I leave the building. I've wrote most of this waiting to see my prothletist about getting a new leg built, which insurance is not going to cover. Medicare and most insuranc will pay $14,000 for the leg I need. Since I'm paying cash I'll get it done for about $8,900 whch should say a lot about health care in this country.
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    There is plenty of money in the system... Just all goes to administrative BS... I went for a prescription refill and got the bill by mistake.... Charge for office visit was $565.00! My portion was $35 under CICP - which is wrong because I got Medicaid so $2.00.... So the state is paying this clinic $563.00 to write a prescription I get filled for $1.00....
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    I feel there is something needs to be done about needing more doctors who would accept Medicaid patients. I have custody of my grandson who has ADHD. Before I retired from my work, my health insurance from work covered him. Now I am retired and on Medicare which only for retired seniors. My grandson have to be put on Medicaid. I have hard time find a doctor who would take Medicaid or they just don't take new patients. I am concerning about how I can have his ADHD medication fill without a doctor to write a prescription. He will be running out of his medication by end of this month. It's very frustrated for me.
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    grandma Wrote: I feel there is something needs to be done about needing more doctors who would accept Medicaid patients. I have custody of my grandson who has ADHD. Before I retired from my work, my health insurance from work covered him. Now I am retired and on Medicare which only for retired seniors. My grandson have to be put on Medicaid. I have hard time find a doctor who would take Medicaid or they just don't take new patients. I am concerning about how I can have his ADHD medication fill without a doctor to write a prescription. He will be running out of his medication by end of this month. It's very frustrated for me.
    Have you looked into the Children's Health Insurance Program? It is a State/Federal program that your grandson may be eligible for.
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    RE: MEDICAID CREDENTIALING/RE-CREDENTIALING in PENNSYLVANIA

    Are there any forum participants who know the most direct way to get up-to-date information on provider Medicaid numbers ?

    There have been changes in the credentialing process and it's very hard to get straight information on credentialing/ re-credentialing in Pennsylvania

    Specifically, it's difficult to reach a live operator knowledgeable about Medicaid credentialing/re-credentialing here in Pennsylvania.

    Thank You !

    Richard Paczynski, MD

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    RE: MEDICAID CREDENTIALING/RE-CREDENTIALING in PENNSYLVANIA

    Are there any forum participants who know the most direct way to get up-to-date information on provider Medicaid numbers ?

    There have been changes in the credentialing process and it's very hard to get straight information on credentialing/ re-credentialing in Pennsylvania

    Specifically, it's difficult to reach a live operator knowledgeable about Medicaid credentialing/re-credentialing here in Pennsylvania.

    Thank You !

    Richard Paczynski, MD