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Equality of Medicaid/Medicare Rates for Primary Care

Author: American College of Physicians

Published: 2010-01-12

Synopsis and Key Points:

Those relying on Medicaid to meet health-care needs include low-income women children minorities and individuals with disabilities.

Main Digest

ACP joins 118 groups supporting equality of Medicaid/Medicare rates for primary care - Letter to Congressional leaders urges acceptance of House provisions in health reform.

The American College of Physicians (ACP) today was one of 118 organizations that joined to send a letter to House and Senate leaders supporting equality of Medicaid and Medicare rates for primary care services. The co-signers include national and state organizations representing physicians, nurses, hospitals, and other health care providers; and consumer, labor, and other patient advocacy groups.

Sent to Majority Leader Reid, Speaker Pelosi and chairmen Rangel, Waxman, Miller, Baucus, Dodd and Harkin, the letter urged the legislators to "ensure meaningful access to care under the proposed Medicaid expansion by adopting [in a final House-Senate health reform agreement] the House provision to bring Medicaid reimbursement rates for primary care in line with comparable Medicare rates within four years."

The letter underscores that the signers strongly support expanding Medicaid to extend health coverage to low-income individuals. However, "we are very concerned that failure to address reimbursement disparities will weaken an already fragile network of Medicaid providers at a time when the demand for their services will be growing."

ACP President Joseph W. Stubbs, MD, FACP noted that, "It is critical that while we provide access to care for so many more low-income Americans, we also adjust payments for primary care services so they are equal to Medicare rates."

Medicaid rates average about two-thirds of Medicare rates for primary care services, the letter notes. They are "woefully inadequate to cover the cost of providing care. According to the Congressional Budget Office, the planned expansion will increase enrollment in Medicaid and the Children's Health Insurance Program by as many as 15 million beneficiaries."

Those who rely on Medicaid to meet their health-care needs include millions of low-income women, children, minorities and individuals with disabilities. The inadequacy of Medicaid reimbursement levels must be addressed in conjunction with the Medicaid expansion or we risk leaving our poorest and most medically-vulnerable resident behind despite the remarkable promise offered by health care."

Thanking the Congressional leaders for their consideration, Dr. Stubbs said the letter also closed by asking the Senators and Representatives for "high priority to ensuring access to care for Medicaid beneficiaries by adopting the House provision to adjust Medicaid payments for primary care to at least 100 percent of Medicare rates."

The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 129,000 internal medicine physicians (internists), related sub-specialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter (www.twitter.com/acpinternists) and Facebook (www.facebook.com/acpinternists

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