Is it profitable for health care providers to accept patients on Medicaid?

Medicaid and Medicare are two different kettles of fish, you should forgive the analogy.

I essentially prepaid for my Medicare treatments so far, having incurred almost no expenses yet and having worked my entire adult working life.

(However, I will receive some sort of satisfaction in the fall when I get a knee replacement.)

(Don’t know whether it is relevant here but I also carry an AARP Medigap policy to pick up the slack from Medicare. So my docs get two reimbursements.)

Define profitable here. Medicaid recipients if I understand right, are more like the indigent of the insured having paid little into the system. So they are more of a drain than Medicare who’s recipients worked and paid into it during their working years. I don’t think their health care providers get as much for their services with medicaid but a lot more than from people with no insurance at all.

The providers profit from the quantity of patients that they can get from Medicaid. The Medicaid examination and services may be more cursory (meaning brief and less detailed) than one where the person has regular health insurance.

Medicaid also pays for everything from home care to adaptive equipment (i.e. wheelchairs) to medical supplies (adult diapers, diabetic supplies). The companies that supply these things profit from the quantities of people using the services.

Doctors don’t work for charity.

Quantity is the real key to seeing Medicare and Medicaid patients.

I have a friend who won’t do certain surgical procedures because Medicare doesn’t pay well for that particular operation, but he will accept Medicare for other things.

Sometimes doctors use the Medicare price as a guide for what to charge for procedures.

Medicaid/medicare pay less than private insurance, but guarantee payment (unlike self-pay).

Most practices will create a policy about whether they accept Medicare/medicaid, possibly what proportion of their practice can have it. Their decision may be based on the population they serve or have a charitable element.

@JLeslie “Doctors don’t work for charity.”

I beg to differ. At our varicose vein surgical practice we routinely treat people who are hard up. We will always work with patient’s unique financial situation and put them on a payment plan (even if it’s only $10/month if that’s what they can afford—and yes we treat many for free). Varicose veins can produce chronic venus stasis ulcers which can cripple working class people’s ability to work (often these are standing professions which are a major risk factor for developing venous reflux). They end up with horrible chronic wounds on their ankles that won’t heal and they can’t work and most of them don’t have good health plans from their employer, so they loose their jobs and go on medicaid.

We do it because these are people who need help and it makes the world a better place.

@gorillapaws I want to hug you.

@gorillapaws When I wrote it I almost bothered to write that of course there are doctors who do charity work. There are some that give years of service doing charity work giving their services. But, I don’t think in the case of accepting Medicare and Medicaid it is really charity work. They are getting paid afterall. My MIL couldn’t get her doctor to give her routine test results over the phone or mail her a copy they made her come into the office. When she asked the doctor why she had to come back for that, the doctor answered, “why are you worried about it? Your insurance (Medicare) pays for it.” Sorry, but that sort of thing disgusts me. My aunt has had more repeat xrays and CT scans than I can count on Medicaid. No question some were unnecessary. Some done two weeks apart for the same problem, nothing had changed. Forget that I am disgusted about the amount of radiation they have put into her body. An abuse of the system, and an abuse of her body. That has happened more than once. I’m sure there are wonderful doctors who sacrifice and do things for free or minimal payment when payment is absolutely justified, but there are also a bunch of thieves.

My friend who won’t do some procedures because Medicaire won’t pay enough, he charges self pay triple for many procedures, ridiculous prices that I find obnoxious. A surgery that takes less than 2 hours $7,000. I realize he also has follow up care, but still a lot of money. Another example with this same doctor, he told me he doesn’t understand why a patient in his office for follow up brings up a new issue while there. They should make a separate appointment for that. I can tell you no patient is going to understand being in the doctors office and not talking about what ails them.

I was quoted $90 for a cosmetic procedure which I agreed to, I made another appointment to come back and have it done, which I did and I paid at the time of service. Next month I received a bill showing what my insurance paid and that I still owed $9. To me that is insurance fraud. I called and said I paid the fee quoted to me at the time of service. She tried to explain to me the billing was for the visit and the $90 was for the procedure. Seriously? They quickly offered to wave my $9 I owed, and I explained I am not so worried about the $9 I am upset about the billing to begin with. I wanted to call insurance to make sure they didn’t pay, but didn’t follow up. I bet even if I had there is a 90% chance insurance would not have followed up and asked for their money back. Which in the end raises our premiums.

My girlfriend works in a diagnostic center. I was complaining to her anout how self pay is much much much less for a CT than what my insurance negotiates and I got screwed, literally billing threatened to hunt me down because they know I have insurance and I cant pay the self pay price. Really? I am still disgusted I went along with my husband and paid almost double what I should have plus they received a huge sum from my insurance. My girlfriend agreed and said that aboslutely that is true where she works; her management tells them not to inform patients if they willingly pay the higher price. Can be $3,000 vs $750. There was a bill in troduced in AZ to have pricing easily accesible for patients and the dems and republicans both voted it down.

Sorry to rant, but I have so many examples. I could go on and on. Maybe since you are inside the system you get treated better, with professional courtesies.

By the way my endocrinologist faxed me a script to get my blood drawn even though I have moved out of town and her staff doing the administrative work to get me the results, let alone emailing with me back and forth, basically doing it free of charge because of how the system is set up. I don’t overlook that, I recognize it. Of course her dingaling assistant sent me the wrong results from two months ago and had to do a second fax, but that is besides the point.