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Tuesday, September 24, 2013


One of the few pieces of the Affordable Care Act that I thought made a good bit of sense is the plan to pay Medicare rates to primary care physicians for providing primary care services to Medicaid patients. (Actually, Medicare parity — as meager as it is — would make sense for all Medicaid services.) The bonus is intended to attract more primary care physicians to Medicaid and encourage them to open up their practices to more Medicaid patients. Since it’s all federal money, the two-year incentive isn’t a drain on the Texas treasury. But here’s the rub. The feds and the state are dragging their feet so badly that the program may be almost over before the first bonus gets paid. The latest word from the Texas Medicaid Program — as we reported in a special issue of Action — is that the first payments should come on March 1 of next year and that they should be retroactive to Jan. 1 of this year. Texas isn’t alone in these delays. All in all, this is a terribly poor way to run an incentive program, and it likely won’t recruit many new doctors to Medicaid.

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