Study: RI doctors paid lowest Medicaid rates in the country

Rhode Island spends more than any other state on its Medicaid program per enrollee, but apparently that’s not because local primary-care doctors are getting a windfall.

Doctors in Rhode Island get paid the nation’s lowest reimbursement rates by Medicaid, the state-federal health insurance program for the poor, relative to what private insurers offer, according to a 2009 Urban Institute study flagged by’s Avik Roy.

Rhode Island and New York both pay primary-care doctors rates that are only 29% of what they’d get from private insurers, the least in the nation, the study found. Rhode Island’s payment rate is far below those of the other New England states: Maine (42%), Vermont (54%), Massachusetts (62%), Connecticut (63%) and New Hampshire (73%).

The federal government limits the ability of states to scale back Medicaid coverage. “So, if states need to reduce Medicaid spending, but can’t make less people eligible for Medicaid, what do they do?” Roy writes. “Pay doctors less.” He suggests the Affordable Care Act will force more states to cut doctors’ rates.

Bloomberg’s Josh Barro counters that “expanded [Medicaid] participation is a good thing. The objective of the Medicaid program – which all 50 states have voluntarily agreed to participate in – is to provide health coverage to poor people. When eligible people do not participate, it is a policy failure.”

• Related: Chart: RI elders cost Medicaid 7 times more than kids, families (March 1)

(chart: Avik Roy/Forbes)

5 thoughts on “Study: RI doctors paid lowest Medicaid rates in the country

  1. He suggests the Affordable Care Act will force more states to cut doctors’ rates. I guess the Dr’s will just except this?? Probably not. Many Dr’s will simply stop excepting Medicaid customers.

    • Exactly. If you expand coverage by cutting payments, and more doctors respond by not excepting those patients, you may have made things worse. One thing that the Democrats never understood while they were designing their new system was that health insurance isn’t health care, and giving more people coverage doesn’t help if a doctor is impossible to find. I seem to remember a child dying in Maryland from a tooth infection while fully covered by a state dental program because the waiting list to see a doctor that would take that insurance was too long.

      Ifyou could save money simply by hacking away at reimbursement rates, real insurance companies would already be doing it. The only reason the government gets away with as much as they do is the size of the programs, but that can only hold for so long. Unless the persistently mismanaged economy is an intentional attempt to increase participation in low-income programs, that is.

      I believe that if the government wants to take resources and services from private companies or individuals — whether its rent, or health care, or land — they should pay market rates, but I guess

  2. Rhode Island spends the MOST money per patient in the nation, but reimburses doctors THE LOWEST FEES in the US?

    Someone is stealing a vast amount of money.

    For health reform in Rhode Island, you need Special Federal Prosecutors. The whole system stinks to high heaven.

  3. I work in health care and have seen quite a few doctors packing up and moving to Massachusetts. Now I know why.

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