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ACA’s Medicaid Pay Bump Helped But Benefits Now Lost, Study Says

Health status and access to care improved for Medicaid patients when the Affordable Care Act mandated a temporary rate increase for physicians serving newly insured patients covered through that law’s Medicaid expansion.

But when the mandate for increased physician payments ended and state Medicaid programs reverted to their previous, lower payments, many of those benefits were lost.

Or so reports a new study from the National Bureau of Economic Research.

According to the study, even a $10 rate increase improved access to care enough to reduce by 13 percent Medicaid recipients’ complaints about not being about to find a doctor.  Utilization also increased.  The temporary Medicaid pay increase has even been credited with improving school attendance and reducing chronic absenteeism.

Despite the benefits of the temporary increase in Medicaid payments to physicians, most states returned to lower payments when the mandated ended, most of the gains resulting from the better pay for treating Medicaid patients disappeared, and the disparities between privately insured individuals and Medicaid patients returned to their pre-Affordable Care Act levels.

Researchers estimate that increasing Medicaid payments to physicians by an average of $26 a visit would eliminate disparities in access to care.

These findings are especially relevant to private safety-net hospitals because the communities they serve have so many more Medicaid patients than the typical American community.

Learn more from the National Bureau of Economic Resarch study “The Impacts of Physician Payments on Patient Access, Use, and Health” and from the Healthcare Dive report “Even $10 increase in Medicaid payments helps erase disparities in care access, study says.”

Journal Looks at Health Disparities

The journal Health Affairs looks at health disparities and social determinants of health in its August 2016 issue.

health affairsThe article “Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health” looks at interventions that focus on social determinants of health, addresses how such interventions can reduce health disparities and improve population health, and considers the challenges to implementing such approaches. Find it here.

The article “Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research” also looks at health care disparities and how to address them, focusing on cardiovascular disease and cancer. Find it here.

Communities served by private safety-net hospitals usually suffer from the very health disparities policy-makers are currently working to address.

Docs Less Likely to Participate in ACOs in Disadvantaged Communities

A new study has found that physicians who practice in areas with higher proportions of low-income, uninsured, less-educated, disabled, and African-American residents are less likely than others to participate in accountable care organizations.

If ACOs ultimately are found to improve health care quality while better managing costs, their benefits might be limited in such communities, thereby exacerbating health care disparities.

It also would be disadvantageous to many of the communities served by the nation’s private safety-net hospitals.

health affairsTo learn more, go here to see the Health Affairs report “Physicians’ Participation In ACOs Is Lower In Places With Vulnerable Populations Than In More Affluent Communities.”

Tracking Medicare Disparities

Tracking disparities in medical conditions and outcomes will be easier with the help of a new “Mapping Medicare Disparities Tool” created by the Centers for Medicare & Medicaid Services’ Office of Minority Health.

cmsThe new disparities tool identifies disparities in utilization, outcomes, and spending by race, ethnicity, and geographic location. It tracks 18 chronic medical conditions along with ER use, readmissions, and other measures, providing data according to state, county, gender, age, dual eligibility status, race, and ethnicity.

To learn more about the Mapping Medicare Disparities Tool, go here to see a CMS news release describing the tool and go here to see and experiment with the tool itself.