Doctors brace for return of financial pain as 2-year Medicaid raise expires

More than half of Ohio's primary care doctors will keep seeing the same number of Medicaid recipients after a significant but temporary pay boost expires at year's end – while 7 percent say they'll stop accepting Medicaid entirely, according to a survey by two physician trade groups.

The Affordable Care Act raised Medicaid payments for two years to equal Medicare for certain primary care services, mainly assessments and vaccinations. On Jan. 1 rates go back to their previous levels – about 59 cents on the dollar compared to what Medicare pays.
An Urban Institute study last week estimated Ohio doctors face a 45 percent pay cut for 27 procedures it examined.

The expiration has caused widespread worry that patients on Medicaid, especially new enrollees under expanded eligibility, would have trouble finding a doctor.
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Ohio has 10,000 physicians in family practice, internal medicine and pediatrics who qualified for the pay boost. The bulk of Ohio Medicaid is administered by private managed care plans; starting in mid-2013 the state sent plans quarterly lump payments to pass through to doctors.
Even though doctors knew all along the increase was temporary, Medicaid rates had been flat for several years, so erasing the raise exacerbates a problem building for a long time, said Ann Spicer, executive vice president of the Ohio Academy of Family Physicians.