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Patients' access to primary care at risk if payment parity
policy allowed to expire
October 27, 2014
WASHINGTON, DC-The American Academy of Pediatrics (AAP),
American Academy of Family Physicians (AAFP), American College of
Physicians (ACP) and American Osteopathic Association (AOA) convene
today in Washington, DC to urge Congress to extend current-law
payment parity for primary care and immunization services under
Medicaid for at least two years. Absent congressional action,
federal support for this policy runs out at the end of the year.
Collectively representing nearly 423,000 physicians, the four
groups are meeting with dozens of congressional offices on Capitol
Hill today, with hundreds more meetings taking place as part of a
daylong AAP advocacy training.
As a national average, physicians treating Medicaid patients
have been historically paid 59 percent of what is paid by Medicare
for the same primary care service. This payment disparity can force
pediatricians, family physicians and internal medicine doctors to
limit the number of new Medicaid patients they can afford to take
on, creating barriers for children and families in search of access
to medical care. This access barrier is especially problematic
because Medicaid serves low-income families as well as children and
adults with special health care needs; access to health insurance
is especially important for these vulnerable populations.
Current law increases Medicaid payments for primary care and
immunizations services to Medicare levels for calendar years 2013
and 2014, but funding for this policy expires on Jan. 1, 2015.
Leaders from the AAP, AAFP, ACP and AOA are in Washington today to
urge support for a bill sponsored by Senators Sherrod Brown
(D-Ohio) and Patty Murray (D-Wash.), the Ensuring Access to
Primary Care for Women & Children Act (S. 2694), which
would extend Medicaid-Medicare payment parity for two more
"Since children make up nearly half of all Medicaid patients,
increasing Medicaid payments for primary care services helps
improve access to care for children," said AAP President James M.
Perrin, MD, FAAP. "The improved Medicaid payment rates over the
last two years have already helped pediatricians better address the
needs of children in their communities by providing the resources
and support they need to give the best possible care to their
patients. In order to sustain improved access to care for children
in Medicaid, the parity payments must be extended."
"Without congressional action to extend Medicaid parity with
Medicare, primary care physicians will see an abrupt cut to
Medicaid payments for the care they provide to low-income
families," said AAFP President Robert Wergin, MD, FAAFP. "This
could wipe out the progress of ensuring that low-income Americans
have access to primary medical care. We know from research that
when Medicaid beneficiaries cannot find a physician who accepts new
Medicaid patients, they face the same access problems as those who
have no insurance. They are less likely to have a usual source of
care, which contributes to unnecessary fragmentation and
duplication of services."
"We are speaking for our patients when we urge senators and
representatives to do the right thing and see that current Medicaid
payment rates for primary care and immunizations services are
maintained," said Wayne J. Riley, MD, MPH, MBA, MACP,
president-elect of ACP. "If Congress fails to take action to extend
this vital program, physician participation will be undermined, and
patients will face barriers in accessing primary care."
An April 2014 ACP-member survey found that of the respondents
who indicated they had enrolled in the pay parity program via their
state Medicaid programs, 46 percent would accept fewer Medicaid
patients in 2015 or drop out of Medicaid entirely in 2015 if the
program was allowed to expire on Dec. 31, 2014. If pay parity is
not extended, the nation's primary care physicians will face an
average pay cut of 41 cents on the dollar for providing primary
care services, such as office visits for the treatment of chronic
diseases like high blood pressure and diabetes to the more than 65
million Americans enrolled in Medicaid.
"The number of eligible Medicaid beneficiaries, among the most
vulnerable patient populations, continues to increase throughout
the country," said AOA President Robert S. Juhasz, DO. "Ensuring
access to care from physicians to treat the needs of these patients
is vital to improving the public health of our citizens, and we
believe Congress should extend this important payment parity policy
to that end."
"The nation's pediatricians are joined today by family
physicians, internal medicine and osteopathic physicians with one
resounding message for Congress: unless Medicaid-Medicare payment
parity is extended this year, patients' access to primary care will
decline," said Dr. Perrin. "We urge our national leaders to help
ensure the health of our patients by passing the Ensuring
Access to Primary Care for Women and Children Act without
About the American Academy of Pediatrics
The American Academy of Pediatrics is an organization of 62,000
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 http://www.aap.org or follow @AmerAcadPeds on Twitter
About the American Academy of Family
Founded in 1947, the AAFP represents 115,900 physicians and medical
students nationwide. It is the only medical society devoted solely
to primary care. Approximately one in four of all office visits are
made to family physicians. That is nearly 214 million office visits
each year - nearly 74 million more than the next largest medical
specialty. Today, family physicians provide more care for America's
underserved and rural populations than any other medical specialty.
Family medicine's cornerstone is an ongoing, personal
patient-physician relationship focused on integrated care.
To learn more about the specialty of family medicine, the AAFP's
positions on issues and clinical care, and for downloadable
multi-media highlighting family medicine, visit www.aafp.org/media.
For information about health care, health conditions, and wellness,
please visit the AAFP's award-winning consumer website, www.familydoctor.org.
About the American College of Physicians
The American College of Physicians is the largest
medical specialty organization and the second-largest physician
group in the United States. ACP members include 141,000 internal
medicine physicians (internists), related subspecialists, and
medical students. Internal medicine physicians are specialists who
apply scientific knowledge and clinical expertise to the diagnosis,
treatment, and compassionate care of adults across the spectrum
from health to complex illness. Follow ACP on Twitter and Facebook.
About the American Osteopathic
The American Osteopathic Association (AOA) represents more than
104,000 osteopathic physicians (DOs) and osteopathic medical
students; promotes public health; encourages scientific research;
serves as the primary certifying body for DOs; is the accrediting
agency for osteopathic medical schools; and has federal authority
to accredit hospitals and other health care facilities. More
information on DOs/osteopathic medicine can be found at www.osteopathic.org.
American Academy of Pediatrics: Jamie Poslosky, email@example.com,
American Academy of Family Physicians: Leslie Champlin, Lchampli@aafp.org, 800-274-2237,
American College of Physicians: David B. Kinsman, firstname.lastname@example.org,
American Osteopathic Association: Nicole Grady, email@example.com,