State variation in primary care physician supply: implications for health reform Medicaid expansions.

Research brief Pub Date : 2011-03-01
Peter J Cunningham
{"title":"State variation in primary care physician supply: implications for health reform Medicaid expansions.","authors":"Peter J Cunningham","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>Under the Patient Protection and Affordable Care Act (PPACA), Medicaid enrollment is expected to grow by 16 million people by 2019, an increase of more than 25 percent. Given the unwillingness of many primary care physicians (PCPs) to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand. States with the smallest number of PCPs per capita overall--gen­erally in the South and Mountain West--potentially will see the largest per­centage increases in Medicaid enrollment, according to a new national study by the Center for Studying Health System Change (HSC). In contrast, states with the largest number of PCPs per capita--primarily in the Northeast--will see more modest increases in Medicaid enrollment. Moreover, geograph­ic differences in PCP acceptance of new Medicaid patients reflect differences in overall PCP supply, not geographic differences in PCPs' willingness to treat Medicaid patients. The law also increases Medicaid reimbursement rates for certain services provided by primary care physicians to 100 percent of Medicare rates in 2013 and 2014. However, the reimbursement increases are likely to have the greatest impact in states that already have a large number of PCPs accepting Medicaid patients. In fact, the percent increase of PCPs accepting Medicaid patients in these states is likely to exceed the percent increase of new Medicaid enrollees. The reimbursement increases will have much less impact in states with a relatively small number of PCPs accepting Medicaid patients now because many of these states already reimburse primary care at rates close to or exceeding 100 percent of Medicare. As a result, growth in Medicaid enrollment in these states will greatly outpace growth in the num­ber of primary care physicians willing to treat new Medicaid patients.</p>","PeriodicalId":87738,"journal":{"name":"Research brief","volume":" 19","pages":"1-11"},"PeriodicalIF":0.0000,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research brief","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Under the Patient Protection and Affordable Care Act (PPACA), Medicaid enrollment is expected to grow by 16 million people by 2019, an increase of more than 25 percent. Given the unwillingness of many primary care physicians (PCPs) to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand. States with the smallest number of PCPs per capita overall--gen­erally in the South and Mountain West--potentially will see the largest per­centage increases in Medicaid enrollment, according to a new national study by the Center for Studying Health System Change (HSC). In contrast, states with the largest number of PCPs per capita--primarily in the Northeast--will see more modest increases in Medicaid enrollment. Moreover, geograph­ic differences in PCP acceptance of new Medicaid patients reflect differences in overall PCP supply, not geographic differences in PCPs' willingness to treat Medicaid patients. The law also increases Medicaid reimbursement rates for certain services provided by primary care physicians to 100 percent of Medicare rates in 2013 and 2014. However, the reimbursement increases are likely to have the greatest impact in states that already have a large number of PCPs accepting Medicaid patients. In fact, the percent increase of PCPs accepting Medicaid patients in these states is likely to exceed the percent increase of new Medicaid enrollees. The reimbursement increases will have much less impact in states with a relatively small number of PCPs accepting Medicaid patients now because many of these states already reimburse primary care at rates close to or exceeding 100 percent of Medicare. As a result, growth in Medicaid enrollment in these states will greatly outpace growth in the num­ber of primary care physicians willing to treat new Medicaid patients.

初级保健医生供应的州差异:对医疗改革医疗补助扩大的影响。
根据《患者保护和平价医疗法案》(PPACA),到2019年,医疗补助登记人数预计将增加1600万人,增幅超过25%。考虑到许多初级保健医生(pcp)不愿意治疗新的医疗补助病人,政策制定者和其他人都关心是否有足够的初级保健能力来满足日益增长的需求。根据研究卫生系统变化中心(HSC)的一项新的全国研究,人均pcp数量最少的州-通常在南部和西部山区-可能会看到医疗补助注册人数的最大百分比增长。相比之下,人均pcp人数最多的州——主要在东北部——将看到医疗补助计划注册人数的适度增长。此外,新医疗补助患者接受PCP的地理差异反映了PCP总体供应的差异,而不是PCP治疗医疗补助患者意愿的地理差异。该法案还在2013年和2014年将初级保健医生提供的某些服务的医疗补助报销率提高到医疗保险费率的100%。然而,在那些已经有大量pcp接受医疗补助病人的州,报销额的增加可能会产生最大的影响。事实上,在这些州,接受医疗补助病人的pcp增加的百分比很可能超过新的医疗补助登记人数的增加百分比。在那些接受医疗补助病人的pcp数量相对较少的州,报销增加的影响要小得多,因为这些州中的许多州已经以接近或超过医疗保险100%的比率偿还初级保健。因此,这些州医疗补助计划注册人数的增长将大大超过愿意治疗新医疗补助患者的初级保健医生数量的增长。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信