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Survey Shows State's Docs Have Capacity For Medicaid Expansion

ANN ARBOR -- A new survey shows that Michigan's primary care doctors will continue accepting new patients, including Medicaid patients, as the state's insured population grows under health care reform.

The survey of 714 physicians, conducted via mail from October to December, was conducted by the Center for Healthcare Research & Transformation, in partnership with the Child Health Evaluation and Research Unit at the University of Michigan. The sample has an error possibility of plus or minus 3 percent.

Results of the statewide survey reveal that a large majority (81 percent) of Michigan primary care physicians anticipate being able to accommodate patients who become newly insured in 2014, when health insurance coverage expands significantly under the Patient Protection and Affordable Care Act. Of those physicians, nearly all indicated that they would accept newly eligible Medicaid patients.

"Our October 2012 Issue Brief showed that expanding Medicaid makes good economic sense for the state of Michigan, but what has not been as clear is whether our state's primary care physicians could handle a significant increase in the insured population," said Marianne Udow-Phillips, CHRT's director and a lecturer at the University of Michigan School of Public Health. "This survey answers that question:  Michigan's primary care physicians can meet this increased demand for patients with all types of health insurance coverage, including Medicaid."

Significant findings from the survey include:

* Most Michigan primary care physicians (81 percent) anticipate being able to add newly insured patients to their practices.
* Among those physicians that anticipate being able to accept newly insured patients, more than 90 percent expect to have capacity for new Medicaid patients. Nearly all family physicians (95 percent), pediatricians (95 percent), and internal medicine practitioners (94 percent) expect to accept patients with new Medicaid coverage.
* Even among physicians who do not currently take new Medicaid patients, most indicated that they would take new Medicaid patients (84 percent of pediatricians; 89 percent of family physicians; and 88 percent of general medicine practitioners).
* Almost all primary care physicians who currently accept new Medicaid patients reported that they would have capacity for newly enrolled Medicaid patients in the future (99 percent to 100 percent, depending on type of primary care).
* Most primary care physicians surveyed in Kent, Macomb, Oakland, Washtenaw and Wayne counties -- where the number of newly eligible Medicaid recipients is projected to be the highest if Michigan expands Medicaid -- expected to have capacity for the newly eligible Medicaid recipients (ranging from 56 percent in Kent County to 86 percent in Wayne County).
* Most primary care physicians surveyed in Ottawa, Washtenaw, Kalamazoo, Oakland, and Grand Traverse counties -- where the greatest percentage increase in total Medicaid enrollment is expected if Michigan expands Medicaid -- expected to have capacity for newly eligible Medicaid recipients (ranging from 61 percent in Ottawa County to 84 percent in Washtenaw County).

"We know from research in other states that providing Medicaid coverage improves the physical and mental health of those who get that coverage compared to those who are uninsured. A key question is: will enough primary care providers be available to meet the medical needs of people with new coverage?" says Matthew Davis, M.D., associate professor of pediatrics and internal medicine at the University of Michigan Medical School, and associate professor of public policy at the Gerald R. Ford School of Public Policy at the University of Michigan. "Our research from right here in Michigan indicates that the majority of primary care physicians are ready to welcome patients with new Medicaid coverage. That is great news for hundreds of thousands of Michiganders who could benefit from new coverage under healthcare reform in our state."

CHRT's October 2012 analysis of the economic impact of Medicaid expansion in Michigan showed that the state could save nearly $1 billion over 10 years -- while extending comprehensive health insurance to more than 600,000 Michigan citizens -- if the state expands Medicaid eligibility beginning in 2014 as provided for under the Affordable Care Act.

"The data tell us that Michigan's primary care physicians have the capacity and the will to serve an expanded Medicaid-insured population," says Udow-Phillips. "This is important information for making an informed policy decision on this issue."

For more information, and to review the CHRT survey results in more detail, visit: www.chrt.org/.

Davis and Udow-Phillips are also both members of the UM Institute for Healthcare Policy and Innovation, which brings together more than 400 health care researchers from U-M and beyond.

The Center for Healthcare Research & Transformation sponsors research and public information to promote evidence-based health care delivery, improve population health, and expand access to care. Housed at the University of Michigan, CHRT is a nonprofit partnership between U-M and Blue Cross Blue Shield of Michigan to study and report on the best ideas for improving the effectiveness and efficiency of the health care system.

Founded in 1998, UM's Child Health Evaluation and Research (CHEAR) Unit is a national leader in the analysis of the American health care system and the organization and financing of care for children. Since its inception, the CHEAR Unit has been awarded over $40 million in research grants from federal, state, and foundation sources. The CHEAR Unit comprises core faculty from the Schools of Medicine, Social Work, Dentistry, Pharmacy, Nursing, Public Health, Business and Law. Multidisciplinary teams provide the structure for research of community, state and national child health policies, practices, and programs. There are more than 30 faculty affiliated with CHEAR.

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