I have written a couple of pieces lately documenting the high percentage of physicians who refuse to take Medicaid patients, and some of the reasons for their refusal. One of my pieces prompted a physician to email me with his take on this matter. I am going to quote from that email, but take out identifying information to protect his anonymity. Here’s what he said:
I had the experience of dealing with Medi-Cal (California’s name for its’ Medicaid plan) in the early 90s when I had started a primary care solo practice. Of 40 primary care docs in a 3 mile radius of my office, I was one of three who accepted Medi-Cal.
The payment for any office visit was so low that it bordered on punitive. The state paid approx 1/3 of the average commercial rate at that time and actually decreased the rate and payment over the past 20 years. California, perhaps not unique compared to all states, also had a nasty habit of stopping payment for any Medi-Cal billed services when the budget for that year ran out, even if that was after 7-8 months. Practices that absolutely depended on Medi-Cal reimbursement went unpaid until the start of the next fiscal year, at which time the backdue payments would trickle in until the next stoppage.
I understand that politics is a messy business, and that government spending can be unpredictable. And I realize that in the real business world, the ins and outs of money are often unpredictable, too. But when someone says they’re going to pay you for the service you provide, that payment should be timely and appropriate. Far too often, state Medicaid programs fail on both accounts…(Read more and view comments at Forbes)