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ACA Medicaid Bump Successful in Increasing Pediatric Care to Underserved Children

12/22/2017

Medicaid is an essential program for child health, insuring an estimated 36 percent to 48 percent of U.S. children. In an effort to stimulate additional primary care physician participation in the Medicaid program, Medicaid payments for primary care services received a temporary increase by the Affordable Care Act (ACA) during 2013-14. New research shows the increase resulted in more doctors participating. For the study, “Increased Medicaid Payment and Participation by Office-based PrimaryCare Pediatricians,” in the January 2018 issue of Pediatrics (published online Dec. 22, 2017), researchers compared survey data collected during 2011-12 and 2015-16 by the American Academy of Pediatrics (AAP) from state-stratified random samples of over 10,000 pediatrician members and found that Medicaid participation increased nationally by most indicators. Physicians accepting at least some new patients insured by Medicaid increased 3 percentage points to 77.4 percent; those accepting all new patients insured by Medicaid increased 5.9 percentage points to 43.3 percent; those accepting patients at least as often as new privately-insured patients increased 5.7 percentage points to 55.6 percent; and the average percent of patients insured by Medicaid per provider panel increased 6 percentage points to 31.3 percent while non-participants dropped 2.1 percentage points to 14.6 percent.  Researchers concluded that continued monitoring of physician participation in Medicaid at the national and state levels is vital for guiding policy to optimize timely access to appropriate health care for over 37 million children insured by Medicaid.

Editor’s note: A commentary, “State Medicaid Payment Levels and the Federal ‘Equal Access’Statute” will be published in the same issue of Pediatrics.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds