The biggest headaches for physicians working with Medicaid patients

About 43 percent of physicians receive more claim denials with Medicaid patients than other patients, according to Medscape's 2023 "Doctors Working with Medicaid" report published Aug. 9, which includes survey results from 251 practicing U.S. physicians who currently accept Medicaid patients. 

Here are eight things to know about how Medicaid affects physicians: 

1. Fifty-seven percent of physicians work at practices that do not limit their numbers of non-emergency Medicaid patients, while 43 percent work at practices that do limit Medicaid patients. 

2. Thirty-eight percent of physicians say reimbursement rates affect their decision to take Medicaid patients by a lot. Twenty-five percent are affected some, while 15 percent are not affected much and 22 percent are not affected at all. 

3. About 43 percent of physicians receive more claim denials with Medicaid, while 28 percent do not. 

4. Thirty-three percent of physicians say claim disputes over unapproved services are a moderate issue, while 30 percent say it's a serious issue. Thirteen percent say it is not an issue, and 24 percent say it's a minor issue. 

5. Twenty-eight percent of physicians face claim disputes over patient eligibility often, while 49 percent face them sometimes. Twenty-one percent seldom face issues and 2 percent never do. 

6. The length of time it takes states to reimburse claims is a moderate issue for 37 percent of physicians and a serious issue for 25 percent. It is a minor issue for 22 percent and not an issue for 15. 

7. Almost half of physicians (48 percent) say schedule disruptions by Medicaid patients, such as missed or canceled appointments, are a serious issue. About 34 percent say it's a moderate issue, while 14 percent say it's a minor issue and 4 percent say it's not an issue. 

8. Some of the top routine difficulties physicians report facing with state Medicaid agencies include low reimbursement rates (84 percent), paperwork demands (53 percent), rejected or disputed claims (52 percent), time to reimbursement (30 percent), stringent state rules (28 percent) and coding disagreements (26 percent). 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Featured Podcast