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Medicaid Payments to Primary Care Doctors Will Rise

doctor Soon, another part of the regulations that are included in the Affordable Care Act will take affect. The new law will increase the amount of money that doctors get as reimbursements for treating patients who use Medicaid. The increase will take place starting in 2013, and continuing through 2014.

There are many problems with the current health care system in the United States. The Affordable Care Act (ACA) is a series of health reform regulations that are designed to fix some of those problems. Some portions of the ACA have already taken effect, and more are intended to be implemented in the next few years.

One of the problems going on right now has to do with Medicaid. Primary care doctors who treat a patient who is covered by Medicaid do not get very much back in reimbursement for that care. Primary care doctors focus on preventative care. Although preventative care plays a significant role in helping a person to stay healthy, it is not reflected in the income that a primary care physician makes. They are paid far less than specialists.

Those two factors have led to big problems. There has been a decrease in the number of primary care doctors who are willing to see patients who are covered by Medicaid. There is also a shortage of primary care doctors, as new doctors select other, higher paying, specialties instead. This is happening at a time when we have a huge number of Baby Boomers who are becoming eligible for Medicare and Medicaid.

The newly proposed law would give primary care doctors who see Medicaid patients a pay raise. It would bring the amount of money that they will get reimbursed closer to what they would have gotten if their patient was covered by Medicare, (instead of Medicaid). The raise will take place starting in 2013 and continuing into 2014.

Medicaid is funded both by the federal government and by individual states. The total amount of money the pay raise would require comes to more than $11 billion dollars. It will be covered entirely by federal dollars. Congress has already set aside those funds when the health-care law was first adopted. The money is there.

All of this preparation and planning might be for nothing, though. The Supreme Court heard arguments about specific parts of the Affordable Care Act in March. The Justices of the Supreme Court won’t make their decisions until sometime in June of this year. If they strike the entire ACA, then it is likely that the doctors won’t get a raise to the reimbursement they get for treating patients who use Medicaid. The problem won’t be solved.

Image by Alex Proimos on Flickr