Health care consulting firm Merritt-Hawkins released the results of a survey of doctors across 5 specialties (cardiology, dermatology, orthopedic surgery, obstetrics-gynecology and family practice) in 15 metropolitan markets. The report found the average Medicaid acceptance rate to be 45.7%, down from 55.4% in 2009. Reasons include: some reimbursement rates below cost to deliver service, reimbursement rates lower compared to other payers, and complex billing procedures for Medicaid payment. Boston had the highest acceptance at 73%, while Dallas was lowest at 23%.
An 18-month study of new Medicaid coverage recipients in Oregon shows a 40% higher utilization of ER services compared to those without insurance. This spike appears to contradict predictions that Medicaid expansion would reduce ER visits and save money for participating states. Expansion supporters believe more walk-in clinics and better communication could alleviate this trend, which is being driven by virtually free ER access. Time will tell, as Oregon has recently developed programs intended to change the patterns of ER use.